Two cases of toxoplasmic encephalitis in patients with acute T-cell leukaemia and lymphoma

Two cases of opportunistic cerebral infections in HIV-negative cancer patie nts due to chemotherapy induced immunosuppression are reported, A 61-year-o ld patient with low grade lymphoma (immunocytoma as referred to the Kiel cl assification) developed stereotactical biopsy proven toxoplasmic encephalit is 6 months after initiation of fludarabine treatment. The lymphoma had bee n diagnosed 8 years earlier and had been treated with several different reg imens, In the second case, a 55-year-old patient developed neurological sym ptoms while in complete remission from acute T-cell leukaemia. The patient had been treated with a multidrug chemotherapy regimen including radiothera py of the brain and intrathecal chemotherapy, When toxoplasmic encephalitis was bioptically diagnosed the patient was on maintenance chemotherapy with methotrexate and mercaptopurine for 12 months. The patients' characteristi cs and outcome are reported and the potential pathogenesis is discussed.