Department of Hematology and Oncology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, No. 1678 Dongfang Road, Pudong District, Shanghai, 200127, China.
Center for Diseases Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China.
World J Pediatr. 2023 Nov;19(11):1062-1070. doi: 10.1007/s12519-023-00721-x. Epub 2023 Apr 23.
Chemotherapy and hematopoietic stem cell transplantation (HSCT) can damage the immune system, and may result in a loss of protection from infectious diseases. This study aimed to evaluate the impact of these treatments on the decrease in antibody titers of the measles, mumps, and rubella (MMR) vaccine and seroconversion post-revaccination of MMR.
After completion of treatment for primary diseases, participants received an MMR revaccination. Antibody titers for MMR before revaccination were analyzed for all 110 children. After revaccination, 68 participants received a follow-up evaluation of antibody titer and adverse reaction.
Multivariable analysis showed that therapeutic schedules were the only factor correlated with lack of antibody titers for measles after completing treatment (P = 0.008), while for mumps and rubella, no statistically significant difference was observed. Importantly, our study clearly demonstrated positive seroconversion rates for measles (97.5%), mumps (81.0%), and rubella (93.2%), with antibody levels rising across the board and peaking at around 6 months following revaccination. However, 6 months after revaccination, a downtrend of antibody titer levels was observed, which is comparatively earlier than the waning immunity observed in healthy children. Furthermore, we found MMR revaccination to be safe, with only a single adverse reaction (local pain at the injection site) reported.
MMR revaccination is immunogenic for the population. We suggest periodic monitoring of antibody titers, in addition to a booster vaccination, although the optimal timing of booster vaccination remains to be investigated further.
化疗和造血干细胞移植（HSCT）会损害免疫系统，可能导致对传染病失去保护。本研究旨在评估这些治疗对麻疹、腮腺炎和风疹（MMR）疫苗抗体滴度下降的影响，以及 MMR 再接种后的血清转化率。
在完成主要疾病的治疗后，所有 110 名参与者均接受了 MMR 复种。分析了所有 110 名儿童 MMR 复种前的抗体滴度。复种后，对 68 名参与者进行了抗体滴度和不良反应的随访评估。
多变量分析显示，治疗方案是与治疗后麻疹抗体滴度缺乏相关的唯一因素（P = 0.008），而腮腺炎和风疹则无统计学差异。重要的是，我们的研究清楚地表明，麻疹（97.5%）、腮腺炎（81.0%）和风疹（93.2%）的血清转化率均为阳性，抗体水平全面上升，并在复种后约 6 个月达到峰值。然而，复种后 6 个月，抗体滴度水平呈下降趋势，这比健康儿童观察到的免疫减弱时间更早。此外，我们发现 MMR 复种是安全的，仅报告了 1 例不良反应（注射部位局部疼痛）。
MMR 复种对该人群具有免疫原性。我们建议定期监测抗体滴度，并进行加强免疫接种，尽管加强免疫接种的最佳时机仍需进一步研究。
