The impact of chemotherapy and hematopoietic stem cell transplantation on humoral immunity to vaccine-preventable diseases

Abstract

BACKGROUND, OBJECTIVES
 The antibody titer of vaccine-preventable disease in 70 patients who underwent chemotherapy or haemopoietic stem cell transplantation (HSCT) was assessed in order to evaluate the seroprotection after treatment and the feasibility and the efficacy of a policy of revaccination.
 METHODS
 Serum antibody titers of 70 patients for hepatitis B (HBV), Rubella, Varicella-zoster (VZV), Measles, Mumps, Polio viruses, Clostridium tetani (C. tetani) and Streptococcus pneumoniae (S. Pneumoniae) were analysed.
 RESULTS
 After chemotherapy, a lack of protective antibody titers against HBV, Rubella, VZV, Measles, Mumps, Polio viruses, C. tetani and S. Pneumoniae were found in 53%, 45%, 46%, 46%, 43%, 21-26%, 88% and 55% of patients, respectively. In patients who were tested both before and after chemotherapy, the loss of immunity was respectively 39%, 43%, 38%, 42%, 32%, 33%, and 80%. A low number of B-lymphocytes was associated with the loss of immunity against Measles (p=0.04) whereas a high number of CD8+ T-lymphocytes was associated with the loss of immunity against VZV (p=0.03). A single booster of vaccine dose resulted in a seroprotection for HBV, Rubella, VZV, Measles, Mumps, Polio viruses, C. tetani and S. Pneumoniae in 67%, 83%, 80%, 67%, 33%, 100%, 88% and 67% of patients, respectively.
 After HSCT, the rates of lack and loss of vaccine immunity differ by the infectious disease considered.
 CONCLUSIONS
 We confirm that seroprotection for vaccine-preventable disease is affected by treatment for pediatric malignancy. A single booster dose of vaccine might be a practical way to restore vaccine immunity in patients after chemotherapy.

A Cohort Study on the Immunogenicity and Safety of the Inactivated SARS-CoV-2 Vaccine (BBIBP-CorV) in Patients With Breast Cancer; Does Trastuzumab Interfere With the Outcome?

“…Previous findings suggested that chemotherapy can have profound and long-lasting negative effects on the bone marrow immune system for up to nine months after treatment and so leaving patients vulnerable to opportunity and secondary infections ( 37 ). So, a single booster dose of Covid-19 vaccine might be a beneficial approach to promote vaccine immunity performance after chemotherapy ( 38 ). Immunity response after co-administration of trastuzumab and chemotherapy has synergic effects meaning that in normal circumstances trastuzumab can improve humoral immune response but our study has a revers relationship with it ( 39 ).…”

Revaccination of children with acute lymphoblastic leukemia following completion of chemotherapy

“…Some reports found that the younger age was significantly different in terms of losing protective antibody levels, 2 possibly related to ineffective vaccination or an incomplete national vaccination program at younger ages 14 . Toret et al 2 .…”

“…Toret et al 2 reported 46 fully vaccinated pediatric ALL survivors among whom 93% had nonprotective antibody levels for at least one vaccine-preventable disease. Fayea et al 13 observed that more than 90% of their patients were seronegative for at least one vaccine-preventable disease, and Garonzi et al 14 reported that 83% of their patients had nonprotective antibody levels for at least one vaccine-preventable disease. Cesaro et al's 15 literature searchfrom 1980 to 2013 revealed that the incidence of a lack of protective antibody titersas measured 6-12 months after chemotherapy varied according the type ofvaccine: it was higher for HBV (about 50% of patients) and lower for measles,mumps, rubella (20%-40%), and polio-diphtheria-tetanus (10%-30%) (Table 5).…”

Vacunación en cáncer infantil: revisión de alcance

“…Así mismo, Kotecha et al 21 declararon que en 100 pacientes, el 80% era susceptible a la cepa H3N2, el 67% a la H1N1 y el 88% a la cepa B. -Poliovirus: Garonzi et al 12 reportaron que en 34 pacientes que después de la quimioterapia no tenían protección contra la enfermedad, los títulos de protección para cada tipo de poliovirus era del 26% para el tipo 1, el 24% para el tipo 2 y el 21% para el tipo 3. -Clostridium tetani: Garonzi et al 12…”

“…-Sarampión, paperas y rubéola: Bettoni et al 11 , respecto al sarampión, paperas y rubéola, recomiendan posponer cualquier vacuna viva hasta después del primer año de tratamiento con inhibidores de la tirosina cinasa. En la misma línea, Garonzi et al 12 declaran que la aplicación de inmunobiológicos después de la quimioterapia debe realizarse de 6 a 12 meses posteriores. Otros dos estudios 15,22 recomiendan la revacunación como un medio de bajo costo para la prevención de enfermedades prevenibles, pero no indican el periodo de tiempo para la administración.…”