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Al-Antary E, Henry M, Spruit J, Yankelevich M, Chu R, Ravindranath Y, Savaşan S. Patterns and correlates of preserved humoral immunity to vaccines in children following allogeneic hematopoietic stem cell transplantation. Pediatr Transplant 2021; 25:e13936. [PMID: 33326673 DOI: 10.1111/petr.13936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 09/14/2020] [Accepted: 11/13/2020] [Indexed: 11/29/2022]
Abstract
Data on preservation of vaccine immunity following allogeneic HSCT in children is limited. We investigated vaccine titers and sought correlations with patient characteristics in this study. Twenty-eight cases were retrospectively analyzed. Antibody concentrations against hepatitis A, hepatitis B, 3 poliovirus serotypes, tetanus, diphtheria, measles, mumps, rubella, varicella, and 13 pneumococcus serotypes were measured as part of planned monitoring following HSCT. Protective antibody levels were found for hepatitis A in 79% of the recipients, measles in 54%, all poliovirus serotypes in 50%, tetanus in 50%, rubella in 50%, varicella in 46%, hepatitis B in 46%, mumps in 43%, diphtheria in 29%, and ≥7/13 pneumococcus serotypes in 46%; lowest level observed for diphtheria and highest for hepatitis A prior to starting post-HSCT immunizations. In univariate analysis, patients with non-malignant diseases (P = .03) and without GvHD (P = .04) had more protective titers. A significant positive association was found among vaccine titers against the microorganisms or the serotypes of the same microorganism, which were administered together in the same product, including polio serotypes, diphtheria and tetanus, mumps, measles, and rubella. Higher degrees of sero-positivity are likely to be due to lack of prior chemotherapy in non-malignant disease cases and lesser immunosuppression in patients without GvHD. Monitoring long-term vaccine titers and administering vaccines accordingly could be evaluated for post-HSCT re-immunization practice.
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Affiliation(s)
- Eman Al-Antary
- Children's Hospital of Michigan, Division of Hematology/Oncology, Pediatric Bone Marrow Transplantation Program, Detroit, MI, USA
| | - Meret Henry
- Children's Hospital of Michigan, Division of Hematology/Oncology, Pediatric Bone Marrow Transplantation Program, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Center, Central Michigan University Collage of Medicine, Detroit, MI, USA
| | - Jessica Spruit
- Children's Hospital of Michigan, Division of Hematology/Oncology, Pediatric Bone Marrow Transplantation Program, Detroit, MI, USA.,Wayne State University, School of Nursing, Detroit, MI, USA
| | - Maxim Yankelevich
- Children's Hospital of Michigan, Division of Hematology/Oncology, Pediatric Bone Marrow Transplantation Program, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Center, Wayne State University School of Medicine, Detroit, MI, USA
| | - Roland Chu
- Children's Hospital of Michigan, Division of Hematology/Oncology, Pediatric Bone Marrow Transplantation Program, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Center, Central Michigan University Collage of Medicine, Detroit, MI, USA
| | - Yaddanapudi Ravindranath
- Children's Hospital of Michigan, Division of Hematology/Oncology, Pediatric Bone Marrow Transplantation Program, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Center, Wayne State University School of Medicine, Detroit, MI, USA
| | - Süreyya Savaşan
- Children's Hospital of Michigan, Division of Hematology/Oncology, Pediatric Bone Marrow Transplantation Program, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Center, Central Michigan University Collage of Medicine, Detroit, MI, USA
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Laws HJ, Baumann U, Bogdan C, Burchard G, Christopeit M, Hecht J, Heininger U, Hilgendorf I, Kern W, Kling K, Kobbe G, Külper W, Lehrnbecher T, Meisel R, Simon A, Ullmann A, de Wit M, Zepp F. Impfen bei Immundefizienz. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:588-644. [PMID: 32350583 PMCID: PMC7223132 DOI: 10.1007/s00103-020-03123-w] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Hans-Jürgen Laws
- Klinik für Kinder-Onkologie, -Hämatologie und Klinische Immunologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - Ulrich Baumann
- Klinik für Pädiatrische Pneumologie, Allergologie und Neonatologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Christian Bogdan
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander Universität FAU Erlangen-Nürnberg, Erlangen, Deutschland
- Ständige Impfkommission (STIKO), Robert Koch-Institut, Berlin, Deutschland
| | - Gerd Burchard
- Ständige Impfkommission (STIKO), Robert Koch-Institut, Berlin, Deutschland
- Bernhard-Nocht-Institut für Tropenmedizin, Hamburg, Deutschland
| | - Maximilian Christopeit
- Interdisziplinäre Klinik für Stammzelltransplantation, Universitätsklinikum Eppendorf, Hamburg, Deutschland
| | - Jane Hecht
- Abteilung für Infektionsepidemiologie, Fachgebiet Nosokomiale Infektionen, Surveillance von Antibiotikaresistenz und -verbrauch, Robert Koch-Institut, Berlin, Deutschland
| | - Ulrich Heininger
- Ständige Impfkommission (STIKO), Robert Koch-Institut, Berlin, Deutschland
- Universitäts-Kinderspital beider Basel, Basel, Schweiz
| | - Inken Hilgendorf
- Klinik für Innere Medizin II, Abteilung für Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Jena, Deutschland
| | - Winfried Kern
- Klinik für Innere Medizin II, Abteilung Infektiologie, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - Kerstin Kling
- Abteilung für Infektionsepidemiologie, Fachgebiet Impfprävention, Robert Koch-Institut, Berlin, Deutschland.
| | - Guido Kobbe
- Klinik für Hämatologie, Onkologie und Klinische Immunologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - Wiebe Külper
- Abteilung für Infektionsepidemiologie, Fachgebiet Impfprävention, Robert Koch-Institut, Berlin, Deutschland
| | - Thomas Lehrnbecher
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland
| | - Roland Meisel
- Klinik für Kinder-Onkologie, -Hämatologie und Klinische Immunologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - Arne Simon
- Klinik für Pädiatrische Onkologie und Hämatologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland
| | - Andrew Ullmann
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Maike de Wit
- Klinik für Innere Medizin - Hämatologie, Onkologie und Palliativmedizin, Vivantes Klinikum Neukölln, Berlin, Deutschland
- Klinik für Innere Medizin - Onkologie, Vivantes Auguste-Viktoria-Klinikum, Berlin, Deutschland
| | - Fred Zepp
- Ständige Impfkommission (STIKO), Robert Koch-Institut, Berlin, Deutschland
- Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin Mainz, Mainz, Deutschland
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Immunization Guidelines for Children with Cancer in India. Indian Pediatr 2019. [DOI: 10.1007/s13312-019-1672-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Januszkiewicz-Lewandowska D, Gowin E, Bocian J, Zając-Spychała O, Małecka I, Stryczyńska-Kazubska J, Kałużna E, Avonts D, Wysocka-Leszczyńska J, Wysocki J. Vaccine-Derived Immunity in Children With Cancer-Analysis of Anti-Tetanus and Anti-Diphtheria Antibodies Changes after Completion of Antineoplastic Therapy. Pediatr Blood Cancer 2015; 62:2108-13. [PMID: 26226936 DOI: 10.1002/pbc.25685] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 07/01/2015] [Indexed: 01/04/2023]
Abstract
BACKGROUND Cancer survival rates and longevity of patients after therapy have significantly improved during the last decades. Thus durable protection against infections should be provided. The aim of the study was to compare the levels of vaccine-derived antibodies in children with cancer compared to those of healthy children and to investigate how therapy influences the levels of specific antibodies. PROCEDURE A group of 40 children, diagnosed with acute lymphoblastic leukemia (ALL) or solid tumor (ST), followed in Poznan University of Medical Sciences Department of Pediatric Hematology, Oncology and Bone Marrow Transplantation, were recruited for evaluation of humoral immunity. Antibody levels were checked before treatment and 3, 6, and 12 months after treatment. RESULTS In patients with ALL or ST, levels of IgG against tetanus and diphtheria were significantly lower than in the control group. Among ALL patients, 9% remained negative for tetanus and diphtheria antibodies 12 months after therapy. Among patients with ST 3 months after chemotherapy, there were no protective antibodies in 12% against tetanus, and in 18% against diphtheria. All patients reconstituted immunity 6 and 12 months after therapy. CONCLUSIONS Our data show that a considerable number of cancer patients lose immunity against diphtheria and tetanus after therapy. Compared to ST, patients with ALL lose protective antibody levels more often. Patients with ST reconstituted antibodies after the treatment cessation, while levels in ALL patients remained low.
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Affiliation(s)
- Danuta Januszkiewicz-Lewandowska
- Department of Molecular Pathology, Institute of Human Genetics Polish Academy of Sciences, Poznan, Poland.,Department of Oncology, Hematology and Bone Marrow Transplantation, University of Medical Sciences Poznan, Poznan, Poland.,Department of Medical Diagnostic Poznan, Poznan, Poland
| | - Ewelina Gowin
- Family Medicine Department, University of Medical Sciences Poznan, Poznan, Poland
| | - Joanna Bocian
- Department of Molecular Pathology, Institute of Human Genetics Polish Academy of Sciences, Poznan, Poland
| | - Olga Zając-Spychała
- Department of Oncology, Hematology and Bone Marrow Transplantation, University of Medical Sciences Poznan, Poznan, Poland
| | - Ilona Małecka
- Department of Health Promotion, University of Medical Sciences Poznan, Poznan, Poland
| | | | | | - Dirk Avonts
- Family Medicine Department, University of Ghent, Ghent, Belgium
| | | | - Jacek Wysocki
- Department of Health Promotion, University of Medical Sciences Poznan, Poznan, Poland
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Paulides M, Stöhr W, Laws HJ, Graf N, Lakomek M, Berthold F, Schmitt K, Niggli F, Jürgens H, Bielack S, Koscielniak E, Klingebiel T, Langer T. Antibody levels against tetanus and diphtheria after polychemotherapy for childhood sarcoma: A report from the Late Effects Surveillance System. Vaccine 2011; 29:1565-8. [DOI: 10.1016/j.vaccine.2010.12.084] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Revised: 12/15/2010] [Accepted: 12/20/2010] [Indexed: 10/18/2022]
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van Tilburg CM, Sanders EAM, Rovers MM, Wolfs TFW, Bierings MB. Loss of antibodies and response to (re-)vaccination in children after treatment for acute lymphocytic leukemia: a systematic review. Leukemia 2006; 20:1717-22. [PMID: 16888619 DOI: 10.1038/sj.leu.2404326] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Intensified chemotherapy regimens resulting in improved survival of children with acute lymphocytic leukemia (ALL) lead to concerns about therapy-induced immune damage reflected by the loss of protection of previous immunizations and the efficacy of (re-)vaccination. The severity of secondary immunodeficiency, however, is not clear and knowledge is based on a limited number of studies. We performed a systematic review on literature concerning vaccination data of children with ALL published since 1980. Eight studies fulfilled the inclusion criteria. Regarding antibody titers after treatment, the number of children who had preserved the defined protection level for antibodies differed widely, ranging from 17 to 98% for diphtheria, 27 to 82% for Bordetella pertussis, 20 to 98% for tetanus, 62 to 100% for poliomyelitis, 35 to 100% for Haemophilus influenzae type B (HiB), 29 to 92% for mumps, 29 to 60% for measles and 72 to 92% for rubella. Most patients however responded to revaccination, demonstrating immunological recovery. Although the designs and results of the included studies varied widely, it can be concluded that cytostatic therapy for ALL in children results in a temporarily reduction of specific antibody levels. Memory is preserved but revaccination may be warranted. This is the first systematic review and the best possible current approximation of chemotherapy-induced immune damage in children after ALL treatment.
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Affiliation(s)
- C M van Tilburg
- Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands.
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Fioredda F, Castagnola E. Reply to Laws et al.: Vaccination after the end of chemotherapy for acute lymphoblastic leukaemia in children. Eur J Haematol 2005. [DOI: 10.1111/j.1600-0609.2005.00512.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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