Antibody responses to Hepatitis B and measles-mumps-rubella vaccines in children who received chemotherapy for acute lymphoblastic leukemia

Abstract

Objective To evaluate viral vaccine antibody levels in children with acute lymphoblastic leukemia after chemotherapy and after vaccine booster doses. Methods Antibody levels against hepatitis B, rubella, measles and mumps vaccine antigens were evaluated in 33 children after completing chemotherapy (before and after vaccine booster doses) and the results were compared to the data of 33 healthy children matched for gender, age and social class. Results After chemotherapy, 75.9%, 67.9%, 59.3% and 51.7% of the patients showed low antibody titers that would be unlikely to protect against exposure to measles, rubella, hepatitis B and mumps, respectively. After receiving a vaccine booster dose for these antigens the patients had high antibody levels consistent with potential protection against measles, mumps and hepatitis B, but not against rubella. Conclusion Extra doses of measles-mumps-rubella plus hepatitis B vaccines are recommended in acute lymphoblastic leukemia patients submitted to treatment after hematologic recovery. After this, viral vaccine antibody levels should be verified to define the individual's protective status.

Immunity against hepatitis B and measles vaccination after chemotherapy for acute lymphoblastic leukaemia in children: revaccination policy

“…In this issue Viana et al ( 1 ) discuss immunity after chemotherapy for acute lymphoblastic leukemia whose recostitution does not garantee protection against vaccine preventable disease. Current treatment for acute lymphoblastic leukaemia (ALL) cures the majority of patients but as a consequence it causes severe immunosuppression which may even last after completing chemotherapy.…”

Post-Chemotherapy Titer Status and Need for Revaccination After Treatment for Childhood Cancer

“…9 However, other studies have also shown no effect of age on posttreatment vaccine titers in children with ALL. 16,17 While these studies and ours showed that some trends do exist, what is important is that considerable portions of individuals exhibit loss of immunogenicity against VPDs following chemotherapy in all ages throughout these studies.…”

Loss Of Humeral Immunity In Childhood Cancer Survivors Not Having Undergone Hematopoietic Stem Cell Transplantation.

“…Previous studies demonstrate intensive chemotherapy may cause notable decreases in vaccine-specific antibody titers in childhood cancer survivors (CCS). [1][2][3][4][5][6] In CCS, the loss of protective antibodies poses a risk from vaccine-preventable infections well after immune reconstitution. 7 These potentially life-threatening infections represent an avoidable source of morbidity and mortality and may create potential disease vectors that threaten public health initiatives.…”