[Immunization for children treated for solid tumors: what are the guidelines?].
There is no agreement on immunization of children treated with chemotherapy (CT) for solid tumors. Based on a review of the literature, we have attempted to establish guidelines on this subject. Except for hepatitis B vaccine, there is no argument to support the use of vaccine during CT. After a standard CT, a 3-month washout period appears to be necessary before starting an immunization program for a child not previously vaccinated, or to proceed with the recommended booster injections for diphteria anatoxin, tetanus vaccine, poliomyelitis inactivated vaccine, pertussis vaccine, and haemophilus influenza type b vaccine if the child is less than 5 years old. For mumps, measles, and rubella live vaccines, a longer post-CT washout of 6 months is suggested for the initial immunization, or for a revaccination of a child proved to be negative for all three serologies. Following high-dose CT a minimal 12-months term and a normalization of the blood lymphocytes count is necessary before planning booster injections once having checked for antidiphteria, tetanic, polio, measles, mumps, rubella and +/- haemophilus antibody titles. We don't find any reason to recommend a systematic varicella immunization in pediatric oncology. Pneumococcal vaccine is recommended in case of asplenia. Any other vaccination (BCG, influenza, yellow fever) must be evaluated individually.
Marec-Bérard
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P
Département d'oncologie pédiatrique, centre Léon-Bérard, 28, rue Laënnec, 69373 Lyon, 08, France. marec@lyon.fnclcc.fr
Floret
D
D
Schell
M
M
Mialou
V
V
Frappaz
D
D
Philip
T
T
Bergeron
C
C
D000367:Age Factors; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D007231:Infant, Newborn; D018655:Lymphocyte Count; D008297:Male; D009369:Neoplasms / Q000188:drug therapy*; D017410:Practice Guidelines as Topic
D000970:Antineoplastic Agents