Impact of conventional chemotherapy on levels of antibodies against vaccine-preventable diseases in children treated for cancer.
Intensive chemotherapy in children with malignancies causes partial immune deficiency, including long-term impairment of humoral immunity. We investigated the levels of antibodies against measles, mumps, polio, rubella, diphtheria, tetanus, and Haemophilus type b (Hib) in 139 children at the time of diagnosis of the malignant disease, during chemotherapy, after cessation of intensive treatment, and after re-vaccination. In general, cytostatic therapy resulted in a significant lowering of antibody levels. A decline of antibodies below the protective level as a consequence of cytostatic treatment was observed in 6% of the children for measles and mumps, in 18%, 12%, and 25% for polio types 1, 2, and 3, and in 21% for diphtheria. By contrast, rubella and tetanus antibodies remained within the protective range in all cases of this study. Re-vaccination 3 to 5 months after cessation of chemotherapy produced antibody levels about as high as those measured prior to therapy. Only 6 out of 83 children with previously positive antigen titres did not respond to re-vaccination. Vaccination or re-vaccination failed in 5 of 13 non-responders for more than 1 antigen, indicating a decreased reactability to vaccinations in some patients.
Reinhardt
Dirk
D
University Children's Hospital Muenster, Department of Paediatric Haematology and Oncology, Germany. dreinh@uni-muenster.de
Houliara
Katharina
K
Pekrun
Arnulf
A
Lakomek
Max
M
Krone
Bernd
B
D000293:Adolescent; D000704:Analysis of Variance; D000914:Antibodies, Viral / Q000032:analysis*; D000917:Antibody Formation / Q000276:immunology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003140:Communicable Disease Control; D003141:Communicable Diseases / Q000276:immunology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007109:Immunity; D007115:Immunization Schedule; D007117:Immunization, Secondary; D016867:Immunocompromised Host; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000188:drug therapy* / Q000276:immunology* / Q000473:pathology; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
D000914:Antibodies, Viral