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

Jennifer Yu, Alexander Ja-Ho Chou, Alison Lennox, Phillip Kleiman, Leonard H. Wexler, Paul A. Meyers, Richard Gorlick

Research output: Contribution to journalArticle

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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 pretreatment 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.

Original languageEnglish (US)
Pages (from-to)656-660
Number of pages5
JournalPediatric Blood and Cancer
Volume49
Issue number5
DOIs
StatePublished - Oct 15 2007

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Secondary Immunization
Sarcoma
Pediatrics
Drug Therapy
Poliomyelitis
Antibodies
Hepatitis B
Mumps
Chickenpox
Rubella
Tetanus
Measles
Communicable Diseases
Vaccines
Ewing's Sarcoma
Rhabdomyosarcoma
Osteosarcoma

Keywords

  • Chemotherapy
  • Immunization
  • Pediatric sarcoma

ASJC Scopus subject areas

  • Cancer Research
  • Pediatrics, Perinatology, and Child Health
  • Hematology

Cite this

Loss of antibody titers and effectiveness of revaccination in post-chemotherapy pediatric sarcoma patients. / Yu, Jennifer; Chou, Alexander Ja-Ho; Lennox, Alison; Kleiman, Phillip; Wexler, Leonard H.; Meyers, Paul A.; Gorlick, Richard.

In: Pediatric Blood and Cancer, Vol. 49, No. 5, 15.10.2007, p. 656-660.

Research output: Contribution to journalArticle

Yu, Jennifer ; Chou, Alexander Ja-Ho ; Lennox, Alison ; Kleiman, Phillip ; Wexler, Leonard H. ; Meyers, Paul A. ; Gorlick, Richard. / Loss of antibody titers and effectiveness of revaccination in post-chemotherapy pediatric sarcoma patients. In: Pediatric Blood and Cancer. 2007 ; Vol. 49, No. 5. pp. 656-660.
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AB - 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 pretreatment 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.

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