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

Fioredda, Francesca

doi:10.5581/1516-8484.20120065

Cited by 6 publications

(8 citation statements)

References 10 publications

(16 reference statements)

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“…Vaccination response was inadequate or insufficient in more than half of our patients regardless of the underlying disease, LHT being the group with the lowest antibody titers in agreement with Fioredda et al 31 . Therefore, revaccination with a booster dose should be indicated in patients with leukemia, especially after chemotherapy 32 .…”

Section: Discussionsupporting

confidence: 91%

Study of pneumococcal vaccine response in children with underlying medical conditions

Jms

et al. 2021

Preprint

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Background: Pneumococcal infection causes serious illness in children, especially those with underlying conditions. Although pneumococcal vaccination in the pediatric population is recommended, the immune response to pneumococcal vaccines in this group is usually deficient. The aim of this study was to study the response to pneumococcal vaccines in children with underlying conditions. Methods: A one-year retrospective study on children with underlying conditions attended at the Pediatric Immunology Unit of La Fe University Hospital (Valencia, Spain). Patient demographics, immunosuppressive diseases, pneumococcal vaccination coverage, serum levels of C3, C4, IgA, IgM, IgG, IgG1, IgG2, IgG3, IgG4, blood levels of leukocytes, neutrophils and CD4 and CD8 T lymphocyte were analyzed. Results: A total of 85 children were included in the study. Only 29.41% of them had the complete vaccination schedule, most under 5 years of age (76.00%). Protective levels of pneumococcal antibodies were found only in 48% of the correctly vaccinated patients, whose serum levels of IgG4 and CD4/CD8 ratio were higher than in children with deficient response. Low vaccine response was mostly found among leukemic patients, who exhibited the lowest level of CD4 T lymphocyte. Patients’ age, immunosuppressive therapy, and serum levels of C3, C4, IgG3 and lymphocytes were associated with pneumococcal vaccine response. Conclusion: Most of the patients lacked some dose of pneumococcal vaccine and had an inadequate response. Mathematical models can be useful in clinical practice to detect non responders. Emphasis should be placed on completing a vaccination schedule and, if necessary, revaccination with a booster dose of pneumococcal vaccines.

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Section: Discussionsupporting

confidence: 91%

Study of pneumococcal vaccine response in children with underlying medical conditions

Jms

et al. 2021

Preprint

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“…Рівень захисту від кору у хворих на гостру лімфобластну лейкемію сягав не вище 75% серед досліджуваних когорт, а в середньому становив 60% [35]. Деякі автори зазначають, що пацієнти, які отримують хіміотерапію, мають порушену імунну відповідь після ревакцинації проти кору [15]. У дослідженні Nilsson та співавт.…”

Section: особливості ведення дітей із вторинними гіпогаммаглобулінеміямиunclassified

Clinical and immunological features in children with secondary hypogammaglobulinemiae

Marunchyn¹,

Volokha²

2021

UJPP

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Antibody deficiency may be a manifestation of primary immunodeficiency or can be generated by extrinsic factors. The frequency of secondary hypogammaglobulinemias has increased significantly in recent years in children with oncohematological pathology. Purpose — to study of clinical, biochemical and immunological indicators in children with secondary hypogammaglobulinemiae in order to determine management and treatment tactics. Materials and methods. 52 children with secondary hypogammaglobulinemiae were examined. Children were divided into 4 groups according to the primary diagnosis (acute myeloblastic, lymphoblastic leukemia and mixed phenotype leukemia, glomerulonephritis, nephrotic syndrome). Anamnesis and data of immunological (levels of serum immunoglobulins IgA, IgM, IgG, subpopulations of lymphocytes) evaluation prior to immunoglobulin replacement therapy. Results. Infectious diseases were observed in 22 children (42.3%). Allergic diseases occurred in 11 children (21%). Toxic complications of chemotherapy by internal organs and systems were found in 38 children (73%). Chronic kidney disease was diagnosed in 5 children (10%). The level of IgG was the lowest in children with nephrotic syndrome (2.6±1.54 g/l). The level of T lymphocytes — CD3+ (0.89±0.93x109/l) and T cytotoxic lymphocytes — CD3+CD8+ (0.33±0.38x109/l) were the lowest in the group of children with acute lymphoblastic leukemia. The level of T helper cells (CD3+CD4+) was low in the group of children with acute lymphoblastic (0.39±0.4x109/l) and myeloblastic leukemia (0.69±0.39x109/l). Level of B lymphocytes was low in the group of children with acute lymphoblastic (0.23±0.23x109/l) and myeloblastic leukemia (0), as well as in the group of children with nephrotic syndrome (0.18±0.13x109/l). Conclusions. Infectious diseases are common in children with secondary hypogammaglobulinemiae. In the group of children with acute leukemia bacterial and fungal diseases occurred more frequently and were more severe compared to the group of children with nephrotic syndrome. Therefore children with secondary hypogammaglobulinemia require control of serum immunoglobulin levels before starting immunosuppressive therapy, bone marrow transplantation and after its completion for the timely initiation of immunoglobulin replacement therapy in order to prevent infectious diseases and their complications. There is a need to determine serum antibody levels in children with nephrotic syndrome. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of a participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: secondary hypohammaglobulinemia, children, serum immunoglobulins, subpopulations of lymphocytes, nephrotic syndrome, proteinuria, acute leukemia.

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“…The current UK guidelines recommend a single dose of diphtheria–tetanus–acellular pertussis (DTaP), inactivated poliovirus (IPV), meningococcus C conjugate vaccine (MCC), Haemophilus influenzae type b (Hib) conjugate, and measles–mumps–rubella (MMR) vaccines at 6 months after completion of chemotherapy 5,6 . These recommendations were primarily based upon expert opinion and data from a limited number of published studies 7–10 . The 2017 European Conference on Infections in Leukemia recommended a booster dose of all vaccines after the end of chemotherapy 11 …”

Section: Introductionmentioning

confidence: 99%

Revaccination of children with acute lymphoblastic leukemia following completion of chemotherapy

Anafy

Gilad

Michaan

et al. 2023

Pediatric Blood & Cancer

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Background: Intensive chemotherapy for acute lymphoblastic leukemia (ALL) may affect the immune system and potentially the immune memory causing antibodies provided by vaccination to disappear. There are disagreements regarding the guidelines for posttreatment immunization strategy.Methods: Ninety-six children (aged 1-18 years at diagnosis) who completed chemotherapy for ALL were recruited. Antibody levels in the patient's serum against measles, varicella, polio, pertussis, hepatitis A, and hepatitis B were tested after completion of chemotherapy in patients who were fully vaccinated against these agents.Children who did not have positive serology to specific agents were revaccinated with a single dose accordingly. Antibody concentrations were measured again at least 4 weeks after revaccination. Results:Positive antibody levels varied between the different agents. The highest percentage of positive serology was against polio (87%) and the lowest against pertussis (4%) (p < .001). There were significant differences between patients with high risk (HR) and non-HR ALL regarding serology status for some vaccines. After revaccination, the levels of response to each booster dose were significantly different: 100% after booster dose for varicella and polio, and only 34% after pertussis booster.Conclusions: Loss of humoral protection for vaccine preventable diseases is a common finding among patients with ALL. Revaccination with one dose of vaccine after completion of chemotherapy achieved seroconversion in 34-100% of the patients depending on the type of vaccine. We recommend this revaccination schedule to all children who completed ALL therapy and were previously fully vaccinated.

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

Cited by 6 publications

References 10 publications

Study of pneumococcal vaccine response in children with underlying medical conditions

Study of pneumococcal vaccine response in children with underlying medical conditions

Clinical and immunological features in children with secondary hypogammaglobulinemiae

Revaccination of children with acute lymphoblastic leukemia following completion of chemotherapy

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