小儿恶性肿瘤化疗对疫苗可预防疾病体液免疫的影响
The Impact of Chemotherapy after Pediatric Malignancy on Humoral Immunity to Vaccine-Preventable Diseases.
作者信息
Garonzi Chiara, Balter Rita, Tridello Gloria, Pegoraro Anna, Pegoraro Manuela, Pacenti Monia, Scattolo Novella, Cesaro Simone
机构信息
Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata Verona, Italy.
Microbiology and Virology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Italy.
出版信息
Mediterr J Hematol Infect Dis. 2020 Mar 1;12(1):e2020014. doi: 10.4084/MJHID.2020.014. eCollection 2020.
BACKGROUND/AIM: The antibody titer of vaccine-preventable diseases in pediatric patients who underwent chemotherapy was assessed in order to evaluate the seroprotection after treatment and the feasibility and the efficacy of a policy of revaccination.
METHODS
Serum antibody titers of 55 patients for hepatitis B (HBV), rubella, varicella-zoster (VZV), measles, mumps, polio viruses, () and () were analysed.Results: After chemotherapy, a lack of protective antibody titers against HBV, rubella, VZV, measles, mumps, polio viruses, , and was found in 53%, 45%, 46%, 46%, 43%, 21-26%, 88% and 55% of patients, respectively. In 49 of 55 patients who were tested both before and after chemotherapy for at least a pathogen, the loss of immunity for HBV, rubella, VZV, measles, mumps, polio viruses and was respectively 39%, 43%, 38%, 42%, 32%, 33%, and 80%. A low number of B-lymphocytes was associated with the loss of immunity against measles (p=0.04) whereas a high number of CD8+ T-lymphocytes was associated with the loss of immunity against VZV (p=0.03). A single booster of vaccine dose resulted in a seroprotection for HBV, rubella, VZV, measles, mumps, polio viruses, and in 67%, 83%, 80%, 67%, 33%, 100%, 88% and 67% of patients, respectively.
CONCLUSIONS
We confirm that seroprotection for vaccine-preventable diseases is affected by treatment for pediatric malignancy. A single booster dose of vaccine might be a practical way to restore vaccine immunity in patients after chemotherapy.
背景/目的：评估接受化疗的儿科患者中疫苗可预防疾病的抗体滴度，以评估治疗后的血清保护作用以及再次接种疫苗政策的可行性和有效性。
方法
分析了55例患者针对乙型肝炎（HBV）、风疹、水痘 - 带状疱疹病毒（VZV）、麻疹、腮腺炎、脊髓灰质炎病毒、（此处原文缺失两种病毒名称）的血清抗体滴度。
结果
化疗后，分别有53%、45%、46%、46%、43%、21 - 26%、88%和55%的患者缺乏针对HBV、风疹、VZV、麻疹、腮腺炎、脊髓灰质炎病毒、（此处原文缺失两种病毒名称）的保护性抗体滴度。在55例至少针对一种病原体在化疗前后均进行检测的患者中，49例患者针对HBV、风疹、VZV、麻疹、腮腺炎、脊髓灰质炎病毒和（此处原文缺失两种病毒名称）的免疫丧失率分别为39%、43%、38%、42%、32%、33%和80%。低数量的B淋巴细胞与麻疹免疫丧失相关（p = 0.04），而高数量的CD8 + T淋巴细胞与VZV免疫丧失相关（p = 0.03）。单次加强疫苗剂量分别使67%、83%、80%、67%、33%、100%、88%和67%的患者对HBV、风疹、VZV、麻疹、腮腺炎、脊髓灰质炎病毒、（此处原文缺失两种病毒名称）产生血清保护作用。
结论
我们证实，儿科恶性肿瘤的治疗会影响疫苗可预防疾病的血清保护作用。单次加强疫苗剂量可能是恢复化疗后患者疫苗免疫力的一种实用方法。
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