Immune function in childhood cancer survivors: a Children's Oncology Group review

Guilcher, Gregory M.T.; Rivard, Linda; Huang, Jennifer T.; Wright, Nicola; Anderson, Lynette; Eissa, Hesham; Pelletier, Wendy; Ramachandran, Shanti; Schechter, Tal; Shah, Ami J.; Wong, Ken; Chow, Eric J.

doi:10.1016/s2352-4642(20)30312-6

Cited by 26 publications

(28 citation statements)

References 69 publications

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“…Our results showed the risk remained elevated after five years after the initial cancer diagnosis. Long-term management of paediatric cancer patients continues into adulthood, thus, our findings may inform evidence-based surveillance and prevention measures for skin cancer, 37 ocular 30 or pulmonary dysfunction, 38 and infection 36 in these patients.…”

Section: Discussionmentioning

confidence: 74%

“…These conditions could have arisen as a result of the primary cancer or metastatic disease, treatment toxicity or infection of skins, ocular and pulmonary function. 16 , 30 , 31 , 32 , 33 Others have shown that sepsis, fever and infection are potential complications in paediatric oncology patients 34 , 35 ; survivors may have impaired immune systems, 36 which increases the susceptibility to pathogens. Our results showed the risk remained elevated after five years after the initial cancer diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Multimorbidity patterns and risk of hospitalisation in children: A population cohort study of 3.6 million children in England, with illustrative examples from childhood cancer survivors

Chung¹,

Mueller²,

Green³

et al. 2022

The Lancet Regional Health - Europe

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Multimorbidity patterns and risk of hospitalisation in children: A population cohort study of 3.6 million children in England, with illustrative examples from childhood cancer survivors

Chung¹,

Mueller²,

Green³

et al. 2022

The Lancet Regional Health - Europe

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“…58 Hematologic cancers and treatments can impair a patient's immune system, resulting in potential chronic immune deficiency. 59 Poor HPV vaccine adherence and delayed vaccination among these patients may be a consequence of survivorship complications. Nonetheless, the clinical predictors of delayed HPV vaccine uptake identified in our study are of particular concern given that childhood cancer survivors are at increased risk of HPV-associated secondary cancers.…”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, hematologic cancers have demonstrated more heterogeneity in clinical outcomes compared to solid tumor cancers, 57 and represent the most common cancers diagnosed in children in the United States 58 . Hematologic cancers and treatments can impair a patient's immune system, resulting in potential chronic immune deficiency 59 . Poor HPV vaccine adherence and delayed vaccination among these patients may be a consequence of survivorship complications.…”

Section: Discussionmentioning

confidence: 99%

Human papillomavirus vaccination uptake among childhood cancer survivors in Western New York

Garcia

McGillicuddy

Rodriguez

et al. 2022

Pediatric Blood & Cancer

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Introduction The risk of human papillomavirus (HPV)‐associated cancers is significantly higher among survivors of a childhood cancer compared to the general population. Despite this, their HPV vaccine uptake rates are lower. We examined factors related to HPV vaccine uptake among childhood cancer survivors from Western New York over 13 years following the introduction of HPV vaccines. Methods Retrospective review of patients diagnosed with invasive or noninvasive cancerous conditions at age 9 or younger treated at Roswell Park Oishei Children's Cancer and Blood Disorder Program. We matched vaccine date information for patients aged 9–26 years between 2006 and 2020 from the New York State Immunization Information System. Demographic and cancer‐related information was abstracted from electronic medical records. Cumulative vaccine uptake was assessed by Kaplan–Meier and Cox proportional hazards regression models. Results A total of 284 patients were included in the analyses. Most were non‐Hispanic/White (80.3%) and resided in a metropolitan area (81.7%). Approximately half had leukemia or lymphoma (54.9%), and most received chemotherapy. Females were more likely to initiate the HPV vaccine and did so sooner (median = 5.5 years) than males (median = 5.7 years; log‐rank p = .301). Patients who were older at vaccine eligibility and males who received blood product transfusions were significantly less likely to initiate the HPV vaccine. Conclusion While rates of HPV vaccine initiation have been increasing with time among childhood cancer survivors, they remain low overall, with differences seen by treatment and diagnosis. Our findings support the need for further research to optimize HPV vaccine delivery in cancer care.

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“…Although diminished or lost vaccination immunity has been documented during or after chemotherapy [12,13], the long-term effects of BRMs on decreasing vaccine immunity (for both live and non-live vaccines) have received far less attention, especially in non-cancer patients [14]. In patients with hematological malignancies, the influenza vaccine response was dramatically reduced within 6 months after the last rituximab dose [15].…”

Section: Discussionmentioning

confidence: 99%

Antibody waning after immunosuppressive chemotherapy and immunomodulators, re-immunization considerations in pediatric patients with malignancy and chronic immune thrombocytopenic purpura

et al. 2022

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Introduction Immunosuppressive chemotherapy increase the risk of vaccine-preventable infectious diseases in children; nevertheless, chemotherapy may result in delay or miss updated immunization schedules. The predictable antibody waning after incomplete primary immunization series may be intensified at the end of chemotherapy. This study aimed to investigate post-chemotherapy vaccine immunity waning at the end of immunosuppressive therapy in children with malignancy and hematologic disorders. Materials and methods Children with malignancies and hematologic disorders including chronic immune thrombocytopenic purpura (ITP) younger than 18 years old were enrolled from September 2015 to August 2019. Eligible patients who completed their treatment protocol for at least 6 months were recruited. The patient information, including sex, age at the date of diagnosis, number of chemotherapy sessions, underlying disease, and vaccination history, was taken by chart review using predefined questionnaires. The patient’s blood samples were obtained, and serum IgG antibody titer checked against diphtheria, tetanus, hepatitis B virus (HBV), mumps, measles, and rubella (MMR) were measured by enzyme-linked immunosorbent assay (ELISA). Results 110 children receiving immunosuppressive chemotherapy were recruited. Forty-four (40%) of the children tested were girls and 66 (60%) were boys. The mean age of patients was 5.5 years with a range of 2 to 13 years. Of 110 studied children, 27.3% were seronegative for all antibodies. On average, patients undergo 19 episodes of chemotherapy. The mean chemotherapy sessions were significantly greater in children who were seronegative for all tested antibodies (mean: 36.2, 95% CI 33.16 to 39.24, p-value < 0.001). No statistically significant differences were observed regarding the patient’s sex and age between the seropositive and seronegative groups (p-value 0.513 and 0.060, respectively). Based on Poisson regression model analysis, the female gender was associated with 37% lower odds of seronegativity (incidence rate ratio (IIR): 0.63; [95% conf. interval: 0.39 to 1.01, p-value: 0.55]), while chemotherapy sessions 30 or more was associated with significant odds of seronegativity for all tested vaccines (IIR: 25.41; [95% conf. interval: 6.42 to 100.57, p-value < 0.001]). Conclusion Our results reemphasized planned catchup immunization in children undergoing immunosuppressive chemotherapy for malignancy, especially against tetanus, diphtheria, and hepatitis B at least 6 months after the end of chemotherapy sessions.

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Immune function in childhood cancer survivors: a Children's Oncology Group review

Cited by 26 publications

References 69 publications

Multimorbidity patterns and risk of hospitalisation in children: A population cohort study of 3.6 million children in England, with illustrative examples from childhood cancer survivors

Multimorbidity patterns and risk of hospitalisation in children: A population cohort study of 3.6 million children in England, with illustrative examples from childhood cancer survivors

Human papillomavirus vaccination uptake among childhood cancer survivors in Western New York

Antibody waning after immunosuppressive chemotherapy and immunomodulators, re-immunization considerations in pediatric patients with malignancy and chronic immune thrombocytopenic purpura

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