Matkowska-Kocjan Agnieszka, Chybicka Alicja
Katedra i Klinika Transplantacji Szpiku, Onkologii i Hematologii Dzieciecej, Akademii Medycznej we Wrocławiu, 50-345 Wrocław.
Med Wieku Rozwoj. 2009 Oct-Dec;13(4):302-10.
One of the most important elements in prophylaxis of infectious diseases of children, is vaccination. It is essential that vaccination should be used correctly and safely in children in immunosupression, including the patients suffering from haematological malignancies. Oncological diseases as well as anticancer therapy disturb the functioning of the immunological system. Particulary deep immunosupression is observed in patients who have undergone stem cell transplantation. For this reason most vaccinations should be temporarily suspended during the period of oncological treatment. After completing the therapy, vaccination can be restarted in accordance with modified schedules. More and more children are now cured of malignancies. Therefore, the vaccination issue is gaining importance. Although we continually broaden our knowledge in this field there still remain several unanswered questions. Moreover, vaccination schedules are different in various countries and oncohaematological centres. This article is an attempt to analyse the data from current Polish and foreign literature on vaccination in children after standard chemotherapy or stem cell transplantation. The following obligatory and recommended vaccinations have been considered: antiviral (measles, mumps, rubella, polio virus, hepatitis B virus, influenza, varicella - zoster virus, human papilloma virus) and antibacterial (diphtheria, tetanus, pertussis, Haemophilus influenzae b, meningococcial and pneumococcal infections, tuberculosis).
儿童传染病预防中最重要的因素之一是疫苗接种。在免疫抑制的儿童中，包括患有血液系统恶性肿瘤的患者，正确且安全地使用疫苗接种至关重要。肿瘤疾病以及抗癌治疗会干扰免疫系统的功能。在接受干细胞移植的患者中尤其会观察到深度免疫抑制。因此，在肿瘤治疗期间，大多数疫苗接种应暂时暂停。治疗完成后，可根据修改后的时间表重新开始接种疫苗。现在越来越多的儿童治愈了恶性肿瘤。因此，疫苗接种问题变得越来越重要。尽管我们在这一领域的知识不断拓宽，但仍有几个问题没有答案。此外，不同国家和肿瘤血液学中心的疫苗接种时间表也不同。本文试图分析当前波兰和国外文献中关于儿童在标准化疗或干细胞移植后疫苗接种的数据。已考虑以下强制性和推荐性疫苗接种：抗病毒（麻疹、腮腺炎、风疹、脊髓灰质炎病毒、乙型肝炎病毒、流感、水痘 - 带状疱疹病毒、人乳头瘤病毒）和抗菌（白喉、破伤风、百日咳、b型流感嗜血杆菌、脑膜炎球菌和肺炎球菌感染、结核病）。
