Hepatitis B Vaccination in Children With Ongoing Cancer Treatment: A Safety and Efficacy Study of Super-Accelerated Vaccination Scheme

Abstract

Objective: Children with cancer have an increased risk for hepatitis B virus (HBV) infections due to chemotherapy-induced secondary immunodeficiency and frequent blood transfusions. The aim of this study is to evaluate the efficacy and safety of hepatitis B vaccination during the intensive induction chemotherapy in children with cancer found to be seronegative for hepatitis B on admission. Materials and Methods: Children newly diagnosed with cancer were evaluated for the presence of hepatitis B surface antigen (HBsAg) and antibody on admission. The children negative for both were included in the study. A super-accelerated vaccination scheme (3 booster doses at days 1-5, 8-12, and 28-33) was administered to these seronegative children concurrently with induction chemotherapy. Antibody response was checked 4-8 weeks after the last vaccination and 6 months after the end of the treatment. Results: Eleven out of 122 children were seronegative for hepatitis B on admission (9%). Acute lymphoblastic leukemia, lymphoma, and solid tumors were diagnosed in 5, 4, and 2 children, respectively. Complete seroconversion was achieved in 4-8 weeks after the last vaccination with high titers of anti-HBs antibody, and all patients remained antibody-positive until 6 months after the completion of chemotherapy. Conclusion: The risk of transfusion-related infections increases with a number of transfused products and donor exposures, and it is more significant for immunosuppressed children with hematologic and oncologic malignancies. Hepatitis B vaccination could safely be applied with brisk and sustained responses in this vulnerable population, based on the local epidemiological data.

Seroprevalence of Hepatitis A, B, and C in Syrian Refugee Children Newly Diagnosed With Cancer

“…Toret et al 13 found that 39% of leukemia patients had hepatitis A seronegativity before treatment, which increased to 83% 6 months after the cessation of therapy. Immunization of hepatitis A and B seronegative children with cancer before or during therapy is well-established in terms of safety and efficacy 14,15 . Yetgin and colleagues studied hepatitis B seroprevalence in children with leukemia based on the status and timing of HBV vaccination.…”

“…Immunization of hepatitis A and B seronegative children with cancer before or during therapy is well-established in terms of safety and efficacy. 14,15 Yetgin and colleagues studied hepatitis B seroprevalence in children with leukemia based on the status and timing of HBV vaccination. They discovered that children vaccinated prior to diagnosis had the lowest percentage of HBV infection, i.e.…”

Current vaccination status and safety of children with peripheral neuroblastoma in the real-world

“…Immunization, an essential approach to bolster immune function and reduce infections, also plays a significant role in enhancing the prognosis of immune levels in children with tumors ( 28 , 29 ). Research has demonstrated a low occurrence of adverse reactions among vaccinated children ( 30 ), including those diagnosed with neuroblastoma ( 31 , 32 ).…”