Vaccine immunity in children after hematologic cancer treatment : a retrospective single-center study

Article Article scientifique Article Vaccine immunity in children after hematologic cancer treatment : a retrospective single-center study eng 2023-11-03 2024-01-01 author Cetin Mélissa Geneva University Hospitals, Faculty of Medicine. 849634 author Gumy Pause Fabienne 0000-0002-2835-4367 Pediatric Oncology and Hematology Unit, Department of Women, Child and Adolescent, University Hospitals of Geneva.,CANSEARCH Research Platform for Pediatric Oncology and Hematology, Department of Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva. 133418 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) author Gualtieri Renato 0000-0001-8164-7284 Pediatric Platform for Clinical Research, Department of Woman, Child and Adolescent Medicine, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Geneva, Switzerland. 974851 author Posfay Barbe Klara Pediatric Infectious Diseases Unit, Department of Pediatrics, Gynecology and Obstetrics, Division of General Pediatrics, Geneva University Hospitals and Faculty of Medicine. 39230 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) author Blanchard Rohner Géraldine 0000-0002-9974-2172 Immunology and Vaccinology Unit, Department of Pediatrics, Gynecology and Obstetrics, Division of General Pediatrics, Geneva University Hospitals, University of Geneva, Geneva, Switzerland. 518713 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) e51-e59 10.1097/MPH.0000000000002774 37922437 1077-4114 PMC10756701 https://journals.lww.com/jpho-online/fulltext/2024/01000/vaccine_immunity_in_children_after_hematologic.15.aspx Background: Children lose their vaccine-induced protection and are particularly vulnerable to vaccine-preventable diseases after chemotherapy. However, revaccination guidelines are heterogeneous, and there is often a lack of revaccination post-treatment. Aims: We conducted a retrospective study of children with hematologic cancer to evaluate vaccine immunity before and after the end of treatment and to determine whether the current institutional revaccination program based on vaccine serology results was followed and effective. Materials and methods: Data of all children treated by chemotherapy between April 2015 and July 2021 were extracted from hospital medical records for analysis. Serum antibody levels and time of vaccination were evaluated for diphtheria, tetanus, Streptococcus pneumoniae , Haemophilus influenzae type b (Hib), measles, varicella, and hepatitis B. Results: We included 31 patients (median age, 9 years). At cancer diagnosis, 90% of children were protected against tetanus, diphtheria, and measles; 65% to 67% were protected against pneumococcus and varicella; and 25% against hepatitis B. At the end of chemotherapy, 67% to 71% of patients were protected against tetanus, varicella, and measles; 40% remained protected against hepatitis B; and 27% to 33% against pneumococcus and diphtheria. Patients were revaccinated at various times after the end of treatment but not systematically. During the first-year post-treatment, 20% to 25% of children remained unprotected against pneumococcus, measles, and hepatitis B, one third against diphtheria, but all were protected against tetanus and varicella. Conclusions: An effective individualized vaccination program post-cancer based on serology results should be accompanied by an appropriate serology tracking method and follow-up to assess if booster doses are necessary. Our study supports vaccinating all children with a dose of the 13-valent pneumococcal conjugate at cancer diagnosis and at 3 months post-treatment with the combined diphtheria-tetanus-acellular pertussis/poliomyelitis vaccine/hepatitis B virus plus or minus Hib and 13-valent pneumococcal conjugate and meningococcal vaccine, including measles/mumps/rubella-varicella zoster virus vaccine if good immune reconstitution is present. Child Humans Infant Retrospective Studies Tetanus / prevention & control Diphtheria / prevention & control Chickenpox Diphtheria-Tetanus-acellular Pertussis Vaccines Hematologic Neoplasms Hepatitis B Neoplasms / drug therapy Measles Dewey 618 58 Département de pédiatrie, gynécologie et obstétrique 223 false 143 Centre de vaccinologie et d'immunologie néonatale 177 564 Oncologie et hématologie pédiatriques 907 515 Recherche en infectiologie pédiatrique et en pédiatrie générale 853 1337 Laboratoire d'immunologie vaccinale humaine 1025 Journal of pediatric hematology/oncology 46 1 7c45be08-9399-42ee-9abd-160929288dad Article (Published version) Public Article_scientifique_from_europePmc.pdf 775284 application/pdf CC BY-NC-ND-4.0 69c7bea8083419459437610c8529bf88e5d80fe8b831afba8c9306777e90f14b openAccess Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique

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Vaccine immunity in children after hematologic cancer treatment : a retrospective single-center study	Journal of pediatric hematology/oncology			2024	70	204

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Cetin, Mélissa