Laboratory diagnosis and clinical significance of rubella in children with cancer.

Virus-specific antibody responses were studied in 12 children with cancer in whom rubella was diagnosed by seroconversion or a rising titre (greater than or equal to fourfold) of haemagglutination inhibiting (HI) antibody. Our results confirmed the difficulties of making a diagnosis of rubella infection in immunocompromised children using criteria for interpreting antibody assays established in immunocompetent patients. Specific IgM antibody persisted for more than 2 months in 7 of 10 children with probable primary rubella, 3 of whom had high concentrations of such antibody 6, 7 and 11 months after the rash. Radial haemolysis and specific IgG1 and IgG3 antibody responses were low in 4, 2, and 4 patients, respectively. One child apparently had a rubella reinfection and, in another, rubella antibody passively acquired from blood transfusions was probably responsible for the HI seroconversion. Nonetheless, the benign clinical course of rubella in immunocompromised children was confirmed.