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儿童急性淋巴细胞白血病幸存者对麻疹、腮腺炎和风疹疫苗的体液免疫反应。

Humoral immune response of childhood acute lymphoblastic leukemia survivors against the measles, mumps, and rubella vaccination.

作者信息

Fouda Ashraf E, Kandil Shaimaa M, Boujettif Fatimah, Salama Yasmin S, Fayea Najwa Y

机构信息

a Pediatric Department, Mansoura University Children's Hospital, Faculty of Medicine , Mansoura University , Al-Mansoura , Egypt.

b Medical School , University of Nicosia , Nicosia , Cyprus.

出版信息

Hematology. 2018 Oct;23(9):590-595. doi: 10.1080/10245332.2018.1460035. Epub 2018 Apr 3.

Abstract

BACKGROUND

There is a great risk of infection with viral-vaccine-preventable diseases like measles, mumps, and rubella (MMR) infections after the end of chemotherapy treatment of children with acute lymphoblastic leukemia (ALL), which could have been prevented with MMR vaccination. Previous studies reported widely variable rates of seropositivity (seroprotection) for MMR after ALL treatment ends. Also, few studies evaluated the response to MMR booster vaccinations after the end of ALL treatment and reported unclear and difficult to interpret results.

MATERIAL AND METHODS

This retrospective cross-sectional study evaluated the prevalence of seropositive (protection) antibody titer levels for MMR among ALL childhood survivors who were followed-up at Jeddah Oncology Center, Saudi Arabia. The aim of the study was also to investigate and analyze the response of seronegative patients to a booster MMR vaccination.

RESULTS

Fifty-seven ALL children were evaluated. Thirty-five patients (61.4%) were seropositive/seroprotected and the remaining 22 patients (38.6%) were seronegative for MMR. ALL Children under the age of 5 years had a higher prevalence of seronegative titers. Interestingly, the prevalence of seroprotection decreased as the time interval increased post-treatment, while seroconversion rates after administering a booster MMR vaccine were 57.1%, 87.5%, and 78.6%, respectively for MMR.

CONCLUSION

We suggest the need for booster MMR vaccination, especially for ALL children under the age of 5 years and those who experienced a protracted time interval post-treatment.

摘要

背景

急性淋巴细胞白血病(ALL)患儿化疗结束后,感染麻疹、腮腺炎和风疹(MMR)等可通过疫苗预防的病毒性疾病的风险很高,而MMR疫苗本可预防此类感染。此前的研究报告称,ALL治疗结束后MMR的血清阳性率(血清保护率)差异很大。此外,很少有研究评估ALL治疗结束后MMR加强疫苗接种的反应,报告的结果不明确且难以解读。

材料与方法

这项回顾性横断面研究评估了在沙特阿拉伯吉达肿瘤中心接受随访的ALL儿童幸存者中MMR血清阳性(有保护作用)抗体滴度水平的患病率。该研究的目的还包括调查和分析血清阴性患者对MMR加强疫苗接种的反应。

结果

对57名ALL儿童进行了评估。35名患者(61.4%)血清阳性/有血清保护作用,其余22名患者(38.6%)MMR血清阴性。5岁以下的ALL儿童血清阴性滴度的患病率较高。有趣的是,血清保护率随治疗后时间间隔的增加而降低,而接种MMR加强疫苗后的血清转化率分别为MMR的57.1%、87.5%和78.6%。

结论

我们建议需要进行MMR加强疫苗接种,尤其是对于5岁以下的ALL儿童以及治疗后时间间隔较长的儿童。

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