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Assessment of humoral immunity to poliomyelitis, tetanus, hepatitis B, measles, rubella, and mumps in children after chemotherapy
Author(s) -
Zignol Matteo,
Peracchi Marta,
Tridello Gloria,
Pillon Marta,
Fregonese Federica,
D'Elia Ruggiero,
Zanesco Luigi,
Cesaro Simone
Publication year - 2004
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.20384
Subject(s) - medicine , rubella , measles , vaccination , tetanus , immunity , immunology , poliomyelitis , antibody titer , hepatitis b , antibody , measles mumps rubella vaccine , booster dose , immunization , titer , virology , immune system
BACKGROUND To 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. METHODS Serum 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. RESULTS Overall, 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%. CONCLUSIONS Chemotherapy 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.