Yilmazbas Pinar, Susam Sen Hilal, Ocak Suheyla
Department of Pediatrics, Health Science University, Okmeydani Training and Research Hospital, Istanbul, Turkey.
Department of Pediatric Hematology Oncology, Health Science University, Okmeydani Training and Research Hospital, Istanbul, Turkey.
Eurasian J Med. 2021 Feb;53(1):5-8. doi: 10.5152/eurasianjmed.2020.20047.
After chemotherapy, cancer survivors suffer from acquired immunological defects and become vulnerable to vaccine-preventable diseases. There are no universally approved revaccination guidelines for non-transplanted oncology patients. This study aimed to share our experience of revaccination in childhood cancer survivors to plan future vaccination schedules.
This retrospective study was conducted in a Pediatric Oncology Department of a university-affiliated hospital. Patients who were diagnosed with malignancy other than leukemia constituted the study population. Patients were directed for revaccination 6 months after the cessation of treatment. Revaccination was performed according to patients' vaccination status before chemotherapy and seronegativity.
Of the 64 patients in the study, 44 (68.75%) were boys. The mean age at the time of diagnosis and at start of vaccination was 8.8±5.3 years and 10.6±5.1 years, respectively. Hodgkin's lymphoma was the most common diagnosis. The vaccination schedule of 7 patients was interrupted because of chemotherapy; after completing the missing vaccine doses, the serology of 2 patients was negative for at least 2 antigens. The vaccination schedule of 57 patients was completed before beginning chemotherapy and 52 of them were seronegative for at least 1 antigen. No adverse reactions or life-threatening infections were observed because of vaccinations.
There are different approaches when vaccinating the oncology patients after chemotherapy. Watching out for the four touchstones mentioned in our study will protect the patient and do no harm. More studies are needed to constitute universal and standardized revaccination guidelines for these patients.
化疗后,癌症幸存者会出现获得性免疫缺陷,易患疫苗可预防疾病。对于非移植肿瘤患者,尚无普遍认可的再接种指南。本研究旨在分享我们在儿童癌症幸存者中进行再接种的经验,以规划未来的疫苗接种时间表。
本回顾性研究在一家大学附属医院的儿科肿瘤科进行。被诊断患有除白血病以外恶性肿瘤的患者构成研究人群。患者在治疗结束6个月后接受再接种。根据患者化疗前的疫苗接种状况和血清阴性情况进行再接种。
研究中的64例患者中,44例(68.75%)为男性。诊断时和开始接种时的平均年龄分别为8.8±5.3岁和10.6±5.1岁。霍奇金淋巴瘤是最常见的诊断。7例患者的疫苗接种计划因化疗而中断;在完成遗漏的疫苗接种剂量后,2例患者的血清学检测显示至少2种抗原呈阴性。57例患者的疫苗接种计划在化疗开始前完成,其中52例至少1种抗原呈血清阴性。未观察到因接种疫苗引起的不良反应或危及生命的感染。
化疗后肿瘤患者接种疫苗有不同的方法。留意我们研究中提到的四个检验标准将保护患者且无害。需要更多研究来制定针对这些患者的通用和标准化再接种指南。