Keskin Yildirim Zuhal, Buyukavci Mustafa
Division of Pediatric Hematology/Oncology, Faculty of Medicine, Atatürk University, Erzurum.
Division of Pediatric Hematology/Oncology, Faculty of Medicine, Sakarya University, Sakarya, Turkey.
J Pediatr Hematol Oncol. 2018 Mar;40(2):e99-e102. doi: 10.1097/MPH.0000000000001072.
Cancer survival rates and longevity of patients after therapy have significantly improved during the last few decades. Therefore, lasting protection against infections should be provided.
A total of 162 children diagnosed with acute lymphoblastic leukemia, acute myelogenous leukemia, solid tumors, non-Hodgkin lymphoma, and Hodgkin lymphoma were enrolled in the study. Antibody levels against hepatitis B virus was assessed both at the time of diagnosis and within 6 months after completion of chemotherapy. However, measles, mumps, and rubella (MMR) antibodies levels were measured just within 6 months after completion of chemotherapy.
Anti-HBs antibody titers had decreased below the protective level after treatment in 25 of 96 patients having protective antibody levels for hepatitis B virus before therapy. In 66 patients without pretreatment protective levels of antibody, in spite of the immunization during chemotherapy, only 6 of them were found to be anti-HBS positive after treatment. In 153 patients previously vaccinated with MMR, 19 had protective antibody titers after treatment. MMR seropositivities were negatively correlated to age as expected.
Our data demonstrate that a significant number of children lose preexisting humoral immunity against MMR and hepatitis B after completion of chemotherapy.
在过去几十年中，癌症患者治疗后的生存率和寿命显著提高。因此，应提供针对感染的持久保护。
共有162名被诊断为急性淋巴细胞白血病、急性髓性白血病、实体瘤、非霍奇金淋巴瘤和霍奇金淋巴瘤的儿童参加了该研究。在诊断时和化疗完成后6个月内评估乙肝病毒抗体水平。然而，仅在化疗完成后6个月内测量麻疹、腮腺炎和风疹（MMR）抗体水平。
在治疗前对乙肝病毒具有保护性抗体水平的96例患者中，有25例在治疗后抗-HBs抗体滴度降至保护水平以下。在66例治疗前无抗体保护水平的患者中，尽管在化疗期间进行了免疫接种，但治疗后仅发现其中6例抗-HBS呈阳性。在153例先前接种过MMR疫苗的患者中，有19例在治疗后具有保护性抗体滴度。正如预期的那样，MMR血清阳性率与年龄呈负相关。
我们的数据表明，相当数量的儿童在化疗完成后失去了对MMR和乙肝的原有体液免疫。
