Köksal Yavuz, Varan Ali, Aydin G Burca, Sari Neriman, Yazici Nalan, Yalcin Bilgehan, Kutluk Tezer, Akyuz Canan, Büyükpamukçu Münevver
Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, Ankara, Turkey.
Pediatr Hematol Oncol. 2007 Dec;24(8):587-94. doi: 10.1080/08880010701703511.
The aim of this study was to determine the efficacy of immunization against hepatitis A and B infections with "rapid" or "accelerated" schedules in children with cancer receiving chemotherapy. Fifty-one children were recruited to receive either vaccination schedule, in the "rapid vaccination schedule"; hepatitis B (group I) or combined hepatitis A/B vaccines (group III) were administered at months 0, 1, 2, and 12; in the "accelerated vaccination schedule," hepatitis B (group II) or combined hepatitis A/B (group IV) vaccines were administered on days 0, 7, 21, and 365 intramuscularly. The seroconversion rates at months 1 and 3 were 35.7 and 57.1% in group I and 25 and 18.8% in group II, respectively. Group I developed higher seroconversion rates at month 3. In group III the seroconversion rates for hepatitis B at months 1 and 3 were 54.5 and 60% and in group IV 50 and 70%, respectively. For hepatitis A, the seroconversion rates at months 1 and 3 were 81.8 and 90% in group III and 80 and 88.9% in group IV, respectively. The accelerated vaccination schedule seems to have no advantage in children receiving cancer chemotherapy except for high antibody levels at month 1. In conclusion, the accelerated vaccination schedules are not good choices for cancer patients. The combined hepatitis A/B vaccine is more effective than monovalent vaccine in cancer patients, which probably can be explained by an adjuvant effect of the antigens. The seroconversion of hepatitis A by the combined hepatitis A/B vaccination is very good in cancer patients.
本研究的目的是确定在接受化疗的癌症患儿中采用“快速”或“加速”免疫程序接种甲型和乙型肝炎疫苗的效果。招募了51名儿童接受其中一种免疫程序，在“快速免疫程序”中，乙型肝炎疫苗（第一组）或甲型/乙型联合疫苗（第三组）在第0、1、2和12个月接种；在“加速免疫程序”中，乙型肝炎疫苗（第二组）或甲型/乙型联合疫苗（第四组）在第0、7、21和365天进行肌肉注射。第一组在第1个月和第3个月的血清转化率分别为35.7%和57.1%，第二组分别为25%和18.8%。第一组在第3个月的血清转化率更高。在第三组中，乙型肝炎在第1个月和第3个月的血清转化率分别为54.5%和60%，第四组分别为50%和70%。对于甲型肝炎，第三组在第1个月和第3个月的血清转化率分别为81.8%和90%，第四组分别为80%和88.9%。除了在第1个月抗体水平较高外，加速免疫程序对接受癌症化疗的儿童似乎没有优势。总之，加速免疫程序对癌症患者不是好的选择。甲型/乙型联合疫苗在癌症患者中比单价疫苗更有效，这可能可以用抗原的佐剂作用来解释。在癌症患者中，通过甲型/乙型联合疫苗接种甲型肝炎的血清转化非常好。
