Loss of antibody titers and effectiveness of revaccination in post-chemotherapy pediatric sarcoma patients.
BACKGROUND
Little is known about the effects of chemotherapy on patient antibody titers to vaccine-preventable infectious diseases; thus, there is no standard protocol for revaccinating post-chemotherapy patients.


METHODS
To assess losses of detectable antibody titers due to chemotherapy, we retrospectively examined antibody titers for tetanus, varicella, measles, mumps, rubella, hepatitis B, and polio in 109 pediatric sarcoma patients. We also evaluated revaccination data to determine current practices and efficacy of revaccination. We limited our sample to osteosarcoma, Ewing sarcoma, and rhabdomyosarcoma patients to control for the chemotherapy regimen patients received.


RESULTS
Patients had pre-treatment detectable antibody titer that fell within the range of healthy children's antibody titers. However, 71% of patients had post-chemotherapy negative titers for at least one infectious disease. Patients most commonly had negative titers for hepatitis B (64%). Few patients had negative titers for measles (14%), mumps (9%), rubella (4%), polio 1 (0%), polio 2 (2.9%), polio 3 (4.8%), tetanus (5%), or varicella (11%). Revaccinations most frequently administered were hepatitis B and polio.


CONCLUSIONS
Our findings suggest that post-chemotherapy patients may need to be revaccinated against certain vaccine-preventable diseases including hepatitis B, tetanus, varicella, polio, measles, mumps, and rubella. Larger studies need to be performed to establish guidelines for revaccinating post-chemotherapy pediatric patients.
Yu
Jennifer
J
Robert Wood Johnson Medical School, Piscataway, New Jersey, USA.
Chou
Alexander J
AJ
Lennox
Alison
A
Kleiman
Phillip
P
Wexler
Leonard H
LH
Meyers
Paul A
PA
Gorlick
Richard
R
D000293:Adolescent; D000906:Antibodies / Q000032:analysis / Q000187:drug effects*; D000970:Antineoplastic Agents / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male; D009894:Opportunistic Infections / Q000517:prevention & control*; D012516:Osteosarcoma; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012208:Rhabdomyosarcoma; D012509:Sarcoma / Q000150:complications / Q000628:therapy*; D012512:Sarcoma, Ewing; D014611:Vaccination / Q000592:standards*
D000906:Antibodies; D000970:Antineoplastic Agents