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Óskarsson Ý, Thors V, Vias RD, Lúðvíksson BR, Brynjólfsson SF, Gianchecchi E, Razzano I, Montomoli E, Gísli Jónsson Ó, Haraldsson Á. Adequate immune responses to vaccines after chemotherapy for leukaemia diagnosed in childhood. Acta Paediatr 2024; 113:606-614. [PMID: 38140806 DOI: 10.1111/apa.17070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/17/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023]
Abstract
AIM The survival rate after treatment for childhood leukaemia has greatly improved, but could result in protracted immune deficiency. This study examined the immune status of children after chemotherapy and evaluated their responses to immunisation. METHODS Subjects who had completed their treatment for acute lymphoblastic leukaemia at The Children's Hospital Reykjavík, Iceland, during 2011-2020 had blood drawn and were then immunised for influenza in October 2021. Blood was drawn again 4 weeks later and their humoral and cellular responses were measured with a haemagglutination inhibition assay and lymphocyte stimulation test. Antibodies to other immunisations were also evaluated. RESULTS We studied 18 patients (10 male) who had completed their treatment at 3.7-20.3 years of age (mean 9.1), 11-84 months (mean 36.9) before enrolment. Conventional immunological evaluation did not reveal notable abnormalities. The responses to several childhood vaccinations, including the pneumococcal conjugate vaccination, were adequate in most patients. Humoral responses to the influenza vaccine confirmed adequate reactions in all but one patient. Considerable variations were observed in the lymphocyte stimulations tests. CONCLUSION Most patients reacted adequately to immunisation, especially against annual influenza and Streptococcus pneumoniae, reiterating the usefulness of vaccinations. The most appropriate timing for vaccination after treatment still needs to be determined.
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Affiliation(s)
- Ýmir Óskarsson
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Valtýr Thors
- The Children's Hospital Iceland, Landspítali University Hospital, Reykjavík, Iceland
- Department of Medicine, School of Health Sciences, University of Iceland, Reykjavík, Iceland
| | - Rafael Daníel Vias
- Department of Mathematics, Faculty of Physical Sciences, University of Iceland, Reykjavík, Iceland
| | - Björn Rúnar Lúðvíksson
- Department of Medicine, School of Health Sciences, University of Iceland, Reykjavík, Iceland
- Department of Immunology, Landspítali University Hospital, Reykjavík, Iceland
| | - Siggeir Fannar Brynjólfsson
- Department of Medicine, School of Health Sciences, University of Iceland, Reykjavík, Iceland
- Department of Immunology, Landspítali University Hospital, Reykjavík, Iceland
| | | | | | - Emanuele Montomoli
- VisMederi Srl, Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Ólafur Gísli Jónsson
- The Children's Hospital Iceland, Landspítali University Hospital, Reykjavík, Iceland
- Department of Medicine, School of Health Sciences, University of Iceland, Reykjavík, Iceland
| | - Ásgeir Haraldsson
- The Children's Hospital Iceland, Landspítali University Hospital, Reykjavík, Iceland
- Department of Medicine, School of Health Sciences, University of Iceland, Reykjavík, Iceland
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Hofmann G, Zierk J, Sobik B, Wotschofsky Z, Sembill S, Krumbholz M, Metzler M, Karow A. Temporal evolution and differential patterns of cellular reconstitution after therapy for childhood cancers. Sci Rep 2023; 13:4022. [PMID: 36899075 PMCID: PMC10006072 DOI: 10.1038/s41598-023-31217-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 03/08/2023] [Indexed: 03/12/2023] Open
Abstract
The cellular reconstitution after childhood cancer therapy is associated with the risk of infection and efficacy of revaccination. Many studies have described the reconstitution after stem cell transplantation (SCT). The recovery after cancer treatment in children who have not undergone SCT has mainly been investigated in acute lymphoblastic leukemia (ALL), less for solid tumors. Here, we have examined the temporal evolution of total leukocyte, neutrophil and lymphocyte counts as surrogate parameters for the post-therapeutic immune recovery in a cohort of n = 52 patients with ALL in comparison to n = 58 patients with Hodgkin's disease (HD) and n = 22 patients with Ewing sarcoma (ES). Patients with ALL showed an efficient increase in blood counts reaching the age-adjusted lower limits of normal between 4 and 5 months after the end of maintenance therapy. The two groups of patients with HD and ES exhibited a comparably delayed recovery of total leukocytes due to a protracted post-therapeutic lymphopenia which was most pronounced in patients with HD after irradiation. Overall, we observed a clearly more efficient resurgence of total lymphocyte counts in patients aged below 12 years compared to patients aged 12 to 18 years. Our results underline that the kinetics of cellular reconstitution after therapy for HD and ES differ significantly from ALL and depend on treatment regimens and modalities as well as on patient age. This suggests a need for disease, treatment, and age specific recommendations concerning the duration of infection prophylaxis and the timing of revaccination.
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Affiliation(s)
- Gina Hofmann
- Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.,Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Jakob Zierk
- Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.,Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Bettina Sobik
- Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.,Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Zofia Wotschofsky
- Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.,Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Stephanie Sembill
- Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.,Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Manuela Krumbholz
- Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.,Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Markus Metzler
- Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.,Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Axel Karow
- Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany. .,Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.
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Deng P, Yang T, Zhang H, Zhou F, Xue C, Fei Y, Gao Y. Prospective clinical trial of hepatitis B vaccination for children with hematological malignancies: a study on the safety and immunogenicity efficacy. Hum Vaccin Immunother 2021; 17:4578-4586. [PMID: 34403292 DOI: 10.1080/21645515.2021.1953303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Children with hematological malignancies are at increased risk of hepatitis B virus infection. This study assessed the immunogenicity and safety profile of HBV vaccination in pediatric hemato-oncological children. A nonrandomized interventional study was conducted from January 2017 to February 2020 in Shanghai, China. Seventy-three pediatric hemato-oncological children with hepatitis B surface antibody (anti-HBs) titers <10 mIU/ml were recruited. The participants received three doses of recombinant HBV vaccine according to the 0-, 1-, and 6- month immunization schedule. Adverse events following immunization and anti-HBs titers (at baseline, 1 month, and 6 months after inoculation) were recorded. Forty-three males and thirty females with median ages of 9.12 and 9.60 years, respectively, were included. The mean anti-HBs titer was 4.88 ± 2.61 mIU/ml, 893.12 ± 274.12 mIU/ml, and 711.45 ± 337.88 mIU/ml at baseline, one month, and six months after inoculation, respectively (P< .001). A total of fourteen adverse events following immunization were reported, and among them, 5 (6.85%), 5 (6.85%), and 4 (5.48%) events were reported after the first, second, and third inoculation, respectively (P= .927). In conclusions, the HBV vaccine is immunogenic and safe in children with hematological malignancies. It is worth noting that the anti-HBs titer was decreased at the 6-month follow-up, and periodic monitoring of the anti-HBs titer accompanied by timely booster vaccination should be carefully considered.Abbreviations: AEFI: Adverse events following immunization; HBV: Hepatitis B virus; Anti-HBs: Antibody against hepatitis B surface antigen; HBsAg: Hepatitis B surface antigen; APC: Antigen-presenting cell; HSCT: Hemopoietic stem cell transplantation; COVID-19: Corona Virus Disease 2019.
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Affiliation(s)
- Pengfei Deng
- Department of Immunology, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Tian Yang
- Department of Immunology, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Hua Zhang
- Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Fen Zhou
- Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Caoyi Xue
- Department of Immunology, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Yi Fei
- Department of Immunology, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Yijin Gao
- Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
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Suwanpakdee D, Taweesith W, Traivaree C, Rujkijyanont P. HBV Seroprotection and Anamnestic Response to Booster Vaccination in Pediatric Cancer Survivors. Glob Pediatr Health 2021; 8:2333794X211033452. [PMID: 34350309 PMCID: PMC8287357 DOI: 10.1177/2333794x211033452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 06/28/2021] [Indexed: 11/26/2022] Open
Abstract
Hepatitis B is a major global health concern and can be prevented in the era of
vaccination. Impaired immunological memory to primary immunization is a common
chemotherapy-related complication among cancer survivors. The study aimed to
determine protective immunity against hepatitis B virus (HBV) and anamnestic
response to booster vaccination. In all, 107 pediatric cancer survivors
previously immunized with primary hepatitis B vaccination were enrolled. A
hepatitis B booster dose was administered to those with suboptimal
seroprotection (anti-HBs < 10 mIU/mL) and 2 additional doses were
subsequently administered at 1 and 6 months to those whose anti-HBs remained
low. Clinical and serologic parameters were analyzed. Sero-protective rate
against HBV (anti-HBs ≥ 10 mIU/mL) among survivors was 20.6% with geometric mean
titer (GMT) of 95.7 ± 265.6 mIU/mL. Anamnestic response was 61% after a booster
vaccine among those with suboptimal seroprotection and 100% after 2 additional
booster doses among those whose anti-HBs remained low. GMTs among those
survivors after the First and third booster vaccines were 320.0 ± 412.4 mIU/mL
and 826.5 ± 343.8 mIU/mL, respectively. Age at diagnosis was a significant
independent risk factor for adequate seroprotection (adjusted OR = 0.84, 95%CI:
0.71-0.99) with a P-value of .034. No associated risk factors
to predict optimal anamnestic response to booster vaccination were identified.
Loss of immunological memory to primary hepatitis B immunization is an
inevitable complication among most pediatric cancer survivors; therefore,
assessing adequate seroprotection is essentially required. For those with
limited accessibility to serologic tests, completion of full 3-booster-dose
series is alternative and highly recommended.
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Affiliation(s)
| | | | - Chanchai Traivaree
- Phramongkutklao College of Medicine and Phramongkutklao Hospital, Bangkok, Thailand
| | - Piya Rujkijyanont
- Phramongkutklao College of Medicine and Phramongkutklao Hospital, Bangkok, Thailand
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Chemical constituents from basidiomycete Basidioradulum radula culture medium and their cytotoxic effect on human prostate cancer DU-145 cells. Bioorg Chem 2021; 114:105064. [PMID: 34134032 DOI: 10.1016/j.bioorg.2021.105064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/12/2021] [Accepted: 06/02/2021] [Indexed: 11/21/2022]
Abstract
Eight new naphtho[1,2-c]furan derivatives (1-8) along with six known analogues (9-14) were isolated from culture medium of the basidiomycete Basidioradulum radula. The structures of these compounds were identified using spectroscopic analysis, and their absolute configurations were resolved using X-ray diffraction, ECD, and VCD. Compounds 7 and 14 inhibited the cell viability of human prostate cancer DU-145 cells with IC50 values of 7.54 ± 0.03 μM and 5.04 ± 0.03 μM, respectively. At 8 μM, compounds 7 and 14 increased the percentage of apoptotic cells and upregulated the protein expression related to the apoptosis caspase pathways in DU-145 cells. Furthermore, the hallmarks of cells undergoing apoptosis, such as chromatin condensation, were also observed at this concentration. However, compound 7 and 14 showed no effect on the proliferation of splenocytes isolated from cyclophosphamide-induce immunosuppressed mice.
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Williams AP, Bate J, Brooks R, Chisholm J, Clarke SC, Dixon E, Faust SN, Galanopoulou A, Heath PT, Maishman T, Mapstone S, Patel SR, Vora A, Wilding SA, Gray JC. Immune reconstitution in children following chemotherapy for acute leukemia. EJHAEM 2020; 1:142-151. [PMID: 35847713 PMCID: PMC9176016 DOI: 10.1002/jha2.27] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/15/2020] [Accepted: 05/20/2020] [Indexed: 11/09/2022]
Abstract
Although survival rates for pediatric acute lymphoblastic leukemia are now excellent, this is at the expense of prolonged chemotherapy regimens. We report the long-term immune effects in children treated according to the UK Medical Research Council UKALL 2003 protocol. Peripheral blood lymphocyte subsets and immunoglobulin levels were studied in 116 participants, at six time points, during and for 18-month following treatment, with 30-39 patients analyzed at each time point. Total lymphocytes were reduced during maintenance chemotherapy and remained low 18 months following treatment completion. CD4 T cells remained significantly reduced 18 months after treatment, but CD8 cells and natural killer cells recovered to normal values. The fall in naïve B-cell numbers during maintenance was most marked, but numbers recovered rapidly after cessation of treatment. Memory B cells, particularly nonclass-switched memory B cells, remained below normal levels 18 months following treatment. All immunoglobulin subclasses were reduced during treatment compared to normal values, with IgM levels most affected. This study demonstrates that immune reconstitution differs between lymphocyte compartments. Although total B-cell numbers recover rapidly, disruption of memory/naïve balance persists and T-cell compartment persist at 18 months. This highlights the impact of modern chemotherapy regimens on immunity, and thus, infectious susceptibility and response to immunization.
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Affiliation(s)
- Anthony P. Williams
- Faculty of Medicine and Institute for Life SciencesUniversity of SouthamptonSouthamptonUK
| | - Jessica Bate
- NIHR Southampton Clinical Research FacilityNIHR Southampton Biomedical Research Centre and Southampton NIHR CRUK Experimental Cancer Medicine CentreUniversity Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Rachael Brooks
- Faculty of Medicine and Institute for Life SciencesUniversity of SouthamptonSouthamptonUK
| | - Julia Chisholm
- Department of Paediatric OncologyRoyal Marsden HospitalSuttonSurrey
| | - Stuart C. Clarke
- Faculty of Medicine and Institute for Life SciencesUniversity of SouthamptonSouthamptonUK
| | | | - Saul N. Faust
- Faculty of Medicine and Institute for Life SciencesUniversity of SouthamptonSouthamptonUK
| | | | - Paul T. Heath
- Paediatric Infectious Diseases Research Group & Vaccine InstituteSt. George's University of London and St. Georges University Hospitals NHS TrustLondonUK
| | | | - Susan Mapstone
- NIHR Southampton Clinical Research FacilityNIHR Southampton Biomedical Research Centre and Southampton NIHR CRUK Experimental Cancer Medicine CentreUniversity Hospital Southampton NHS Foundation TrustSouthamptonUK
| | | | - Ajay Vora
- Department of Paediatric HaematologyGreat Ormond Street HospitalLondonUK
| | | | - Juliet C. Gray
- Faculty of Medicine and Institute for Life SciencesUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Clinical Research FacilityNIHR Southampton Biomedical Research Centre and Southampton NIHR CRUK Experimental Cancer Medicine CentreUniversity Hospital Southampton NHS Foundation TrustSouthamptonUK
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7
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Fouda AE, Kandil SM, Boujettif F, Salama YS, Fayea NY. Humoral immune response of childhood acute lymphoblastic leukemia survivors against the measles, mumps, and rubella vaccination. ACTA ACUST UNITED AC 2018; 23:590-595. [PMID: 29614919 DOI: 10.1080/10245332.2018.1460035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND There is a great risk of infection with viral-vaccine-preventable diseases like measles, mumps, and rubella (MMR) infections after the end of chemotherapy treatment of children with acute lymphoblastic leukemia (ALL), which could have been prevented with MMR vaccination. Previous studies reported widely variable rates of seropositivity (seroprotection) for MMR after ALL treatment ends. Also, few studies evaluated the response to MMR booster vaccinations after the end of ALL treatment and reported unclear and difficult to interpret results. MATERIAL AND METHODS This retrospective cross-sectional study evaluated the prevalence of seropositive (protection) antibody titer levels for MMR among ALL childhood survivors who were followed-up at Jeddah Oncology Center, Saudi Arabia. The aim of the study was also to investigate and analyze the response of seronegative patients to a booster MMR vaccination. RESULTS Fifty-seven ALL children were evaluated. Thirty-five patients (61.4%) were seropositive/seroprotected and the remaining 22 patients (38.6%) were seronegative for MMR. ALL Children under the age of 5 years had a higher prevalence of seronegative titers. Interestingly, the prevalence of seroprotection decreased as the time interval increased post-treatment, while seroconversion rates after administering a booster MMR vaccine were 57.1%, 87.5%, and 78.6%, respectively for MMR. CONCLUSION We suggest the need for booster MMR vaccination, especially for ALL children under the age of 5 years and those who experienced a protracted time interval post-treatment.
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Affiliation(s)
- Ashraf E Fouda
- a Pediatric Department, Mansoura University Children's Hospital, Faculty of Medicine , Mansoura University , Al-Mansoura , Egypt
| | - Shaimaa M Kandil
- a Pediatric Department, Mansoura University Children's Hospital, Faculty of Medicine , Mansoura University , Al-Mansoura , Egypt
| | | | - Yasmin S Salama
- c Pharmacy Department , Mansoura International Specialized Hospital , Al-Mansoura , Egypt
| | - Najwa Y Fayea
- d Oncology Center Jeddah , King Abdullah Medical City , Makkah , Kingdom of Saudi Arabia
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8
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Assessment of Humoral Immunity to Hepatitis B, Measles, Rubella, and Mumps in Children After Chemotherapy. J Pediatr Hematol Oncol 2018; 40:e99-e102. [PMID: 29309372 DOI: 10.1097/mph.0000000000001072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cancer survival rates and longevity of patients after therapy have significantly improved during the last few decades. Therefore, lasting protection against infections should be provided. PROCEDURE A total of 162 children diagnosed with acute lymphoblastic leukemia, acute myelogenous leukemia, solid tumors, non-Hodgkin lymphoma, and Hodgkin lymphoma were enrolled in the study. Antibody levels against hepatitis B virus was assessed both at the time of diagnosis and within 6 months after completion of chemotherapy. However, measles, mumps, and rubella (MMR) antibodies levels were measured just within 6 months after completion of chemotherapy. RESULTS Anti-HBs antibody titers had decreased below the protective level after treatment in 25 of 96 patients having protective antibody levels for hepatitis B virus before therapy. In 66 patients without pretreatment protective levels of antibody, in spite of the immunization during chemotherapy, only 6 of them were found to be anti-HBS positive after treatment. In 153 patients previously vaccinated with MMR, 19 had protective antibody titers after treatment. MMR seropositivities were negatively correlated to age as expected. CONCLUSIONS Our data demonstrate that a significant number of children lose preexisting humoral immunity against MMR and hepatitis B after completion of chemotherapy.
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10
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Guidelines for the Prophylaxis of Pneumocystis jirovecii Pneumonia (PJP) in Children With Solid Tumors. J Pediatr Hematol Oncol 2017; 39:194-202. [PMID: 28267082 DOI: 10.1097/mph.0000000000000771] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Although it is well-established that children undergoing allogeneic stem cell transplants and treatment for leukemia should be offered prophylaxis against Pneumocystis jirovecii pneumonia, the risk for children with solid malignancies is less certain. This guideline has been developed with the aim of standardizing practice and optimizing the benefit versus risk of prophylactic medication in this group of patients. P. jirovecii pneumonia has a high mortality rate even with prompt antimicrobial treatment. Since prophylaxis with co-trimoxazole is safe, effective, and inexpensive, we suggest that all children with malignancies undergoing immunosuppressive therapy are offered prophylaxis unless there are clear contraindications.
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Guerra RNM, Oliveira-Junior JJ, Mouchrek-Filho JCE, Liberio SA, Lima MVV, Paim DBS, Brito CXL, Mendonça C, Nascimento FRF, Pereira ALA. Salivary evaluation of pediatric patients with cancer, before and after antineoplasic treatment. J Oral Pathol Med 2012; 41:527-32. [PMID: 22687139 DOI: 10.1111/j.1600-0714.2012.01165.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AIMS This study evaluated the salivary biochemical and immunological status of children with cancer undergoing to antineoplasic treatment in an attempt to identify alternatives for a less invasive and less painful monitoring of these patients. MATERIALS AND METHODS Unstimulated whole saliva samples were obtained from 115 children without cancer (control) and 32 children with cancer (CA). Children with cancer were also evaluated after antineoplasic treatment (CAT, n = 17). The salivary concentrations of glucose, triglycerides, total cholesterol, alkaline phosphatase, gamma-glutamyltransferase (GGT), urea, insulin, thyroid-stimulating hormone (TSH), triiodothyronine (T3), levothyroxine (T4), and immunoglobulin A (IgA) were determined. RESULTS Acute lymphocytic leukemia, acute myeloid leukemia, and Hodgkin's lymphoma were the most frequent cancers, although cases of non-Hodgkin's lymphoma, medulloblastoma, ependymoma, osteosarcoma, nephroblastoma, Ewing's sarcoma, and endodermal sinus tumor were also observed. The salivary concentration of cholesterol, triglycerides, or GGT did not differ between groups. Instead, the concentrations of alkaline phosphatase and T4 were higher in patients with cancer, irrespective of treatment. TSH levels were higher in the CA group and urea concentration was lower in the CAT group. T3 was undetectable in all groups. Antineoplasic treatment increased the glucose level and decreased the insulin concentration. Salivary concentration of total IgA was lower in children with cancer, irrespective of treatment. CONCLUSIONS Cancer and antineoplasic treatment affected biochemical and immunological parameters in the saliva of children, shedding new light on the potential usefulness of saliva for monitoring children with cancer, especially to patients undergoing immunosuppressive therapy.
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Affiliation(s)
- Rosane N M Guerra
- Laboratory of Immunophysiology, Centro de Ciencias Biológicas e da Saúde, Universidade Federal do Maranhão, Maranhão, Brazil.
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12
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Aytac S, Yalcin SS, Cetin M, Yetgin S, Gumruk F, Tuncer M, Yurdakok K, Gurgey A. Measles, mumps, and rubella antibody status and response to immunization in children after therapy for acute lymphoblastic leukemia. Pediatr Hematol Oncol 2010; 27:333-43. [PMID: 20469978 DOI: 10.3109/08880011003767720] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Seventy-seven patients with acute lymphoblastic leukemia (ALL) who were in complete remission and whose therapies had been stopped for at least 6 months before enrollment in this study were retrospectively analyzed regarding their antibody status for measles, mumps, and rubella, with the aim to demonstrate the seropositivity rate after treatment in the authors' group. Each patient's serum samples were analyzed by enzyme-linked immunosorbent assay (ELISA) method to determine the antibody titers before and after immunization. Measles serology was available in 77 children; 45 (58%) were seronegative. Initial ages of measle-seronegative patients were statistically lower than those of seropositive cases (median 3.29 versus 4.91 years, respectively). Mumps serology was available in 76 children; 36 (47%) were seronegative. Mumps-seropositive cases tended to have more frequent previous history of infection than seronegative cases (55.0% versus 28.6%, respectively, P = .05). Rubella serology was available in 76 children, and 20 (26.3%) were seronegative. It was determined that initial ages of rubella-seronegative patients were statistically lower than those of seropositive cases (median 3.03 versus 4.32 years, respectively). The authors concluded based on the results of their study that at a median of 3.31 years after completion of chemotherapy for ALL, the majority of cases had antibody levels lower than protective values for measles (58.4%); however, these values were 47.3% for mumps and 26.3% for rubella. Seroconversion rates after measles (55%) and mumps vaccination (57.1%) were still low. However, in the available cases, relatively adequate response to rubella vaccination (92.3%) was observed.
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Affiliation(s)
- Selin Aytac
- Hematology Unit Hacettepe University Ihsan Doğramaci Children's Hospital, Hematology Unit, Ankara, Turkey
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