Loss of antibody titers and effectiveness of revaccination in post-chemotherapy pediatric sarcoma patients.

Abstract:

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. PROCEDURES: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.

journal_name

Pediatr Blood Cancer

journal_title

Pediatric blood & cancer

authors

Yu J,Chou AJ,Lennox A,Kleiman P,Wexler LH,Meyers PA,Gorlick R

doi

10.1002/pbc.21277

subject

Has Abstract

pub_date

2007-10-15 00:00:00

pages

656-60

issue

5

eissn

1545-5009

issn

1545-5017

journal_volume

49

pub_type

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