Application of Live Varicella Vaccine to Children with Acute Leukemia or Other Malignancies Without Suspension of Anticancer Therapy

Abstract

A live varicella vaccine was given to children with acute leukemia or other malignancies with minimal clinical reactions.1 In that study, anticancer medication was suspended beginning one week before vaccination and was not resumed until one week after vaccination. In the present study, we attempted to vaccinate such children without suspension of anticancer medication. SUBJECTS AND METHODS Fifteen children with acute leukemia, 12 children with malignant solid tumors (4 neuroblastoma, 4 retinoblastoma, 2 Wilms tumor, 2 teratocarcinoma), and 1 child with lymphosarcoma received a live varicella vaccine1 (500 plaque forming unit/dose) without suspension of anticancer medication. All of these children had been in remission.

Epidemiology and potential preventative measures for viral infections in children with malignancy and those undergoing hematopoietic cell transplantation

“…Although the varicella vaccine is a live attenuated vaccine, there are multiple publications documenting the safety and effectiveness of the vaccine after administration to children in remission for ALL with or without suspension of maintenance chemotherapy 62, 63. However, the recommendation to hold chemotherapy around the time of vaccination and the report of a fatal event in a child with ALL after varicella vaccination has raised concern about administering the vaccine routinely to patients with ALL 64.…”

Pulmonary Viral Infections in the Immunocompromised Host

“…Initial reports in children suggest that the vaccine can prevent all primary infections and has not been associated with severe disease in immunocompromised hosts. 46 Major developments have occurred also with the use of antiviral agents for treating active VZV infections. Clinical trials have suggested that vidarabine can halt the progression of zoster skin lesions and prevent visceral dissemination (19 versus 5%).…”

Aktive Varizellenimpfung bei Kindern mit akuter Leukämie oder anderen neoplastischen Erkrankungen

“…Die Ergebnisse von 26 chemotherapeutisch behandelten Kindern mit malignen Erkrankungen, die eine Lebend-Varizella-Impfung erhielten, zeigen, daß diese Impfung ohne nennenswerte Nebenwirkungen abläuft. Entsprechende Ergebnisse wurden auch von anderen Gruppen berichtet (2,6,7,10). In unserem Krankengut wurde keine übertragung von Impfvarizellen auf gesunde Personen beobachtet.…”