Dynamic re-immunization of off-treatment childhood cancer survivors: An implementation feasibility study

Han, Jennifer; Harmoney, Kathryn M.; Dokmeci, Elif; Torrez, Jacqueline; Chavez, Cathy M.; Ortega, Loretta Cordova de; Kuttesch, John F.; Muller, Martha; Winter, Stuart S.

doi:10.1371/journal.pone.0191804

Cited by 8 publications

(13 citation statements)

References 19 publications

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“…Previous studies have also shown different rates in loss of immunity for different VPDs within the same patient population. 5,6,8,9,12,18 -26…”

Section: Discussionmentioning

confidence: 99%

“…Han and colleagues show pilot data that immune recovery in patients treated with chemotherapy may be earlier than previously expected and showed safety with reimmunization at 3 months after cessation of chemotherapy. 23 More studies are needed to show early ALC recovery and its relationship with seroresponse to vaccinations.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have also shown different rates in loss of immunity for different VPDs within the same patient population. 5,6,8,9,12,[18][19][20][21][22][23][24][25][26] Bold values are statistically significant. Abbreviation: PCV, pneumococcal conjugate vaccine.…”

Section: Loss Of Vaccine Response Is Significant and Variable After Cmentioning

confidence: 99%

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

Zhang

Thornton

Ruble

et al. 2020

Clin Pediatr (Phila)

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Objectives. To evaluate the strategy of checking vaccine titers after completion of chemotherapy. Study Design. Retrospective review of pediatric oncology patients who completed chemotherapy. Demographics, post-chemotherapy titers, and absolute lymphocyte counts (ALCs) were analyzed. Results. Ninety patients met inclusion criteria, and 87% of patients had at least one titer checked. Comparing patients <7 years and those ≥7 years at diagnosis, there was no difference in incidence of negative titers except mumps; those <7 years old were more likely to have negative titers (58% vs 20%, P = .003). Comparing those <13 years old to ≥13 years old, there was no difference in negative titers except mumps (45% vs 19%, P = .02) and tetanus (44% vs 0%, P = .002). No patient maintained all protective titers after completion of chemotherapy. Time to ALC recovery was not predictive of positive titers. Conclusion. Checking titers after chemotherapy is not recommended. Providers should assume loss of immunity.

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“…Previous studies have also shown different rates in loss of immunity for different VPDs within the same patient population. 5,6,8,9,12,18 -26…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Zhang

Thornton

Ruble

et al. 2020

Clin Pediatr (Phila)

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“…Several studies have shown that a universal one dose schedule of revaccination is bene cial. 10,11 In uenza vaccinations are also recommended for patients and their families.…”

Section: Discussionmentioning

confidence: 99%

Acute Lymphoblastic Leukaemia In A 7-year-old Presenting With Lower Limb Pain – Not Just Your Simple Growing Pains!

Lin¹,

Song’En²

2020

SFP

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This is a case report of a 7-year-old boy who presented with lower limb pain. He was initially presumed to have growing pains but was subsequently diagnosed with acute lymphoblastic leukaemia (ALL). This case highlights the important clinical presentations and differential diagnoses of ALL that a family physician should be cognizant about to avoid misdiagnosis. It also demonstrates the importance of understanding the patient and family's perspectives when evaluating a child with lower limb pain. This enables us to anticipate and meet their needs.

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“…Guidelines generally suggest that most children with cancer begin to receive routine or catch-up vaccines once immunological recovery is complete, approximately 3–6 months following the completion of chemotherapy depending on the type of treatment administered, immunological recovery, and type of vaccine (attenuated vs. non-attenuated) [ 2 – 4 ]. Recent research suggests that among survivors who have not undergone bone marrow transplantation, receipt of attenuated vaccines as early as three months after treatment might result in protective antibody responses [ 5 ]. However, this research is based on small samples of patients in a limited age range.…”

Section: Introductionmentioning

confidence: 99%

Influence of provider recommendations to restart vaccines after childhood cancer on caregiver intention to vaccinate

et al. 2020

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Purpose: We studied the influence of oncology and primary care provider (PCP) recommendations on caregiver intentions to restart vaccines (e.g., catch-up or boosters) after cancer treatment. Methods: We surveyed primary caregivers ages 18 or older with a child who had completed cancer treatment 3–36 months prior (N=145) about demographics, child’s vaccination status, and healthcare factors (e.g., provider recommendations, barriers, preferences for vaccination). We compared these factors by caregiver’s intention to restart vaccines (“vaccine intention” vs. “no intent to vaccinate”) using bivariate and multivariable analyses. Results: Caregivers were primarily ages 30–39 years (54.9%), mothers (80.6%), college graduates (44.4%), Non-Hispanic (89.2%), and married (88.2%). Overall, 34.5% of caregivers did not know which vaccines their child needed. However, 65.5% of caregivers reported vaccine intention. Fewer caregivers with no intention to vaccinate believed vaccinating their child helps protect others (85.4% vs. 99.0%, p<0.01), that vaccines are needed when diseases are rare (83.7% vs. 100.0%, p<0.01), and that vaccines are safe (80.4% vs. 92.6%, p=0.03) and effective (91.5% vs. 98.9%, p=0.04) compared to vaccine intention caregivers, respectively. Provider recommendations increased caregivers’ likelihood of vaccine intention (oncologist: RR=1.65, 95% CI 1.27–2.12, p<0.01; PCP: RR=1.51, 95% CI 1.19–1.94, p<0.01). Conclusions: Provider recommendations positively influence caregivers’ intention to restart vaccines after childhood cancer. Guidelines are needed to support providers in making tailored vaccine recommendations. Implications for Cancer Survivors: Timely vaccination after childhood cancer protects patients against vaccine-preventable diseases during survivorship. Caregivers may benefit from discussing restarting vaccinations after cancer with healthcare providers.

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Dynamic re-immunization of off-treatment childhood cancer survivors: An implementation feasibility study

Cited by 8 publications

References 19 publications

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

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

Acute Lymphoblastic Leukaemia In A 7-year-old Presenting With Lower Limb Pain – Not Just Your Simple Growing Pains!

Influence of provider recommendations to restart vaccines after childhood cancer on caregiver intention to vaccinate

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