Assessment of humoral immunity to poliomyelitis, tetanus, hepatitis B, measles, rubella, and mumps in children after chemotherapy

Abstract

BACKGROUNDTo evaluate the effect of chemotherapy on humoral immunity to vaccine‐preventable disease, the authors investigated the persistence of protective antibody titers in a group of patients who were alive and well after they were treated for pediatric malignancies.METHODSSerum antibody levels were evaluated for polio, tetanus, hepatitis B, rubella, mumps, and measles in 192 children. The terms lack of immunity and loss of immunity, respectively, were used to describe the absence of immunity in patients who were tested only after chemotherapy and in patients who were tested both before and after chemotherapy and determined to have immunity before chemotherapy.RESULTSOverall, the absence of a protective serum antibody titer for hepatitis B, measles, mumps, rubella, tetanus, and polio was detected in 46%, 25%, 26%, 24%, 14%, and 7% of patients, respectively. On univariate analysis, loss of antibodies against rubella, mumps, and tetanus was associated significantly with younger age (P < 0.001, P = 0.02, and P = 0.001, respectively), and loss of antibodies against measles was significantly associated with younger age and female gender (P = 0.0003 and P = 0.008, respectively). The administration of 59 booster vaccinations to 51 patients who had lost ≥ 1 protective antibody titer resulted in an overall response rate of 93%.CONCLUSIONSChemotherapy induced different rates of loss of protective antibody titers depending on the type of vaccination administered. This finding may be responsible for the failure of vaccination programs for patients who have undergone chemotherapy. The administration of a booster dose after the completion of chemotherapy is a simple and cost‐effective way to restore humoral immunity against most vaccine‐preventable diseases. Cancer 2004. © 2004 American Cancer Society.

Humoral immunity to diphtheria, tetanus, measles, and hemophilus influenzae type b in children with acute lymphoblastic leukemia and response to re‐vaccination

“…We agree with the recommendation of many others that ALL patients should be re-vaccinated following completion of chemotherapy [3,6,21,24]. Only Fioredda et al [23] considered administration of another complete vaccination schedule to each ALL subject over treatment taking into account the economical aspect of vaccines and laboratory kits.…”

“…Zignol et al [24] who studied humoral immunity against tetanus, measles, polio, hepatitis B, mumps, rubella in 192 children with cancer showed high protective antibody recovery in 51 patients who lost protective antibody after chemotherapy of hematologic malignancies and solid tumors and suggested a booster dose 12 months after completion of the chemotherapy. Patel et al [21] recommended one booster dose 6 months after completion of chemotherapy in their study of 59 children with ALL and AML.…”

Loss of antibodies and response to (re-)vaccination in children after treatment for acute lymphocytic leukemia: a systematic review

“…First, many studies were excluded from this review as they analyzed patient groups during chemotherapy and/or patient groups with other cancers like other hematological malignancies or solid tumors. [24][25][26][27][28][29][30][31][32][33][34][35][36][37] It was not possible to extract data separately for ALL patients after cessation of chemotherapy from these studies. As a consequence, this review represents homogeneous groups of ALL patients after cessation of chemotherapy.…”

“…The remaining 21 studies were excluded for the following reasons: only groups less than 10 patients were included (n ¼ 2), 19,20 no data extraction possible (n ¼ 1), 21 antibodies against vaccine-preventable disease not analyzed (n ¼ 2), 12,22 results of children could not be distracted from that of adults (n ¼ 1), 23 patients studied were still on chemotherapy (n ¼ 8) [24][25][26][27][28][29][30][31] and results not stratified for ALL patients only (n ¼ 7). [32][33][34][35][36][37][38] Importantly no randomized controlled trials were available.…”

Trifunctional antibodies induce efficient antitumour activity with immune cells from head and neck squamous cell carcinoma patients after radio-chemotherapy treatment

“…Haematologic toxicity is a known side effect of chemotherapy and radiation therapy, and results in transient immunodefi ciency. The resulting impairment of cellular and humoral immunity can last up to several months after the end of treatment [14][15][16][17][18][19]. Combining chemotherapy and trifunctional antibody-based immunotherapy in cancer treatment therefore requires evaluation of the immune response activity that remains after chemotherapy treatment.…”