Center for Advanced Practice, St. Jude Children's Research Hospital, Memphis, TN, USA.
Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA.
J Pediatr Hematol Oncol Nurs. 2024 Sep-Oct;41(5):309-314. doi: 10.1177/27527530231221145. Epub 2024 May 7.
Measles is reemerging as a public health threat, raising important questions about disease vulnerability among childhood cancer survivors. This secondary analysis assessed the seroprevalence of anti-measles immunoglobulin G (IgG) antibodies as a marker of immune status in survivors of childhood cancer and associated demographic/treatment variables. Participants were childhood cancer survivors who were free of active disease, having routine blood studies drawn, and could provide documentation of having received two doses of measles, mumps, and rubella vaccine before their cancer diagnosis. Patient record review documented demographic and treatment variables. Antimeasles (rubeola) IgG antibody seroprevalence was assessed by enzyme immunoassay for vaccine-specific antibodies. Of 270 survivors evaluated, 110 (42%) were female, 196 (75%) were White, and 159 (61%) were leukemia/lymphoma survivors. Of these 262, 110 (42%) had negative measles seroprevalence, suggesting loss of immunity. Measles antibody surveillance and the need for reimmunization for survivors of childhood cancer survivors outside the transplant setting remains controversial. Our analysis indicates that a substantial proportion of survivors lose vaccine-related immunity to measles. Pediatric oncology nurses play important roles in educating cancer survivors regarding their risk of measles infection, evaluating the need for reimmunization, correcting misinformation about vaccine safety and effectiveness, and working to optimize community herd-based immunity.
麻疹作为一种公共卫生威胁再次出现,这引发了人们对儿童癌症幸存者疾病易感性的重要问题。本二次分析评估了麻疹免疫球蛋白 G(IgG)抗体的血清阳性率,作为儿童癌症幸存者免疫状态的标志物,并分析了与人口统计学/治疗相关的变量。参与者为无活动性疾病的儿童癌症幸存者,常规进行血液研究,并能提供在癌症诊断前已接受两剂麻疹、腮腺炎和风疹疫苗的证明。患者病历记录了人口统计学和治疗变量。采用酶联免疫吸附试验检测抗麻疹(风疹)IgG 抗体的血清阳性率。在评估的 270 名幸存者中,有 110 名(42%)为女性,196 名(75%)为白人,159 名(61%)为白血病/淋巴瘤幸存者。在这 262 名幸存者中,有 110 名(42%)的麻疹血清阳性率为阴性,表明免疫力丧失。麻疹抗体监测以及在移植环境之外的儿童癌症幸存者中重新免疫的必要性仍然存在争议。我们的分析表明,相当一部分幸存者失去了麻疹相关的疫苗免疫力。儿科肿瘤护士在教育癌症幸存者麻疹感染风险、评估重新免疫的必要性、纠正有关疫苗安全性和有效性的错误信息以及努力优化社区群体免疫方面发挥着重要作用。