Hepatitis B vaccination and immune response in children with malignant diseases

Abstract

Fifty children with malignant diseases were vaccinated against hepatitis B. Twenty-nine children suffered from leukaemia or non-Hodgkin's lymphoma; 14 of these were on intensive chemotherapy (group I) and 15 were without intensive therapy (group II). The other 21 children had various forms of solid tumours, 14 of them were on intensive therapy (group III) and 7 were without intensive therapy (group IV). To evaluate the immune response, we determined antibody titres over a period of more than 14 weeks after the first vaccination. As 22 out of 50 patients had received passive immunisation together with either the first or the first and second vaccination, antibody titres at the 14th and 18th week (i.e. more than 10 weeks after passive immunisation) were used to evaluate the vaccination results. An antibody titre of greater than or equal to 10 mIU/ml was considered to be a positive response. All patients of group IV, but only 4 out of 14 in group III, 4 out of 15 in group II, and 0 out of 14 in group I produced antibody titres higher than 50 mIU/ml. In contrast to the full response in group IV, two-thirds of all other patients had no immune response (less than 10 mIU/ml). Based on our experience we recommend vaccinating patients suffering from solid tumours and receiving no intensive therapy (group IV) against hepatitis B and protecting all the other children with malignant diseases by passive immunisation, if necessary.

Seroprevalence of hepatitis B, hepatitis C, and human immunodeficiency virus infections in children with cancer at diagnosis and following therapy in Turkey

“…HBV vaccination of these seronegative patients at diagnosis may be recommended [1]. The seroconversion rate following three double doses of vaccine administered at monthly intervals was reported to be 19-41% in children with solid tumors [12,13]. We have also obtained a seroconversion rate of 40% in 25 children with solid tumors (unpublished results).…”

“…We have also obtained a seroconversion rate of 40% in 25 children with solid tumors (unpublished results). In several studies, the best seroconversion rates were obtained in patients who do not receive intensive chemotherapy [12,13]. As antineoplastic therapy intensity increases, the antibody response to chemotherapy decreases.…”

Efficacy of immunization against hepatitis B virus infection in children with cancer

“…This might also cause more immunosuppression in them. Previous studies demonstrated impaired immune response to active vaccination in children with leukemia during intensive chemotherapy [9,10]. Therefore, in our study, children with leukemia had active vaccination after completing the intensive chemotherapy period which might secure a better immune response.…”

Association of hepatitis C virus infection with chronic liver disease in paediatric cancer patients

“…Despite donor screening for hepatitis B, acute and chronic hepatitits B remains a problem on paediatric oncology wards [5,19]. In addition, evidence of chronic non-A-non-B (NANB) hepatitis is found in a significiant proportion of paediatric cancer patients [13,15].…”