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小儿癌症治疗结束后抗体水平及疫苗诱导血清学反应的评估:土耳其关于甲型肝炎、乙型肝炎、水痘带状疱疹病毒及麻疹腮腺炎风疹疫苗接种的6年经验

Assessment of Antibody Levels and Vaccine-induced Serologic Responses After Completion of Cancer Treatment in Pediatric Patients: A 6-Year Experience in Turkey on HAV, HBV, VZV, and MMR Vaccinations.

作者信息

Gundesli Sebiha S, Celik Melda, Yalcin Siddika Songul, Aydin Guzide B, Kurucu Nilgun, Yalcin Bilgehan, Varan Ali, Kutluk Tezer M

机构信息

Department of Pediatrics, Faculty of Medicine, Hacettepe University.

Division of Social Pediatrics, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Vaccine Institute, Hacettepe University.

出版信息

J Pediatr Hematol Oncol. 2025 Jan 1;47(1):e19-e25. doi: 10.1097/MPH.0000000000002961. Epub 2024 Nov 7.

Abstract

OBJECTIVE

Childhood cancer treatment disrupts vaccination schedules and weakens or eliminates vaccine-induced immunity. In addition, post-treatment vaccine responses vary. This study aimed to assess post-treatment serum antibody levels and vaccine responses in children.

METHODS

Pediatric patients treated at Hacettepe University between years 2015 and 2020, achieved remission after chemotherapy for lymphoma and solid tumors were included. Post-treatment vaccination status, serum antibody levels for hepatitis A (HAV), hepatitis B (HBV), varicella-zoster (VZV), measles-mumps-rubella (MMR), and changes in vaccine responses were retrospectively analyzed.

RESULTS

The study included 533 patients. Post-treatment seronegativity rates were: measles (83.5%), HAV (64%), rubella (60.1%), HBV (48.5%), VZV (43.3%), and mumps (28%). Post-treatment antibody loss was observed for measles (47.1%), HAV (31.9%), HBV (31.4%), mumps (28.6%), VZV (21.7%), and rubella (11.4%). Seropositivity after 1 vaccine dose was seen with HAV (83.6%), rubella (82.9%), HBV (81.4%), VZV (63.5%), mumps (45.4%), and measles (33.3%). Seropositivity after 2 vaccine doses was achieved with HAV (98.8%), VZV (84.6%), rubella (80%), HBV (80%), measles (32.2%), and mumps (36.2%).

CONCLUSION

Post-treatment serological vaccine responses in children were lower than anticipated despite multiple doses. Given the potential need for periodic serological assessments and booster vaccinations, long-term follow-ups are planned.

摘要

目的

儿童癌症治疗会打乱疫苗接种计划,削弱或消除疫苗诱导的免疫力。此外,治疗后疫苗反应各不相同。本研究旨在评估儿童治疗后的血清抗体水平和疫苗反应。

方法

纳入2015年至2020年在哈杰泰佩大学接受治疗、化疗后淋巴瘤和实体瘤缓解的儿科患者。回顾性分析治疗后的疫苗接种状况、甲型肝炎(HAV)、乙型肝炎(HBV)、水痘-带状疱疹(VZV)、麻疹-腮腺炎-风疹(MMR)的血清抗体水平以及疫苗反应的变化。

结果

该研究纳入了533例患者。治疗后的血清阴性率分别为:麻疹(83.5%)、甲型肝炎(64%)、风疹(60.1%)、乙型肝炎(48.5%)、水痘-带状疱疹(43.3%)、腮腺炎(28%)。观察到治疗后抗体丢失的情况为:麻疹(47.1%)、甲型肝炎(31.9%)、乙型肝炎(31.4%)、腮腺炎(28.6%)、水痘-带状疱疹(21.7%)、风疹(11.4%)。接种1剂疫苗后的血清阳性率为:甲型肝炎(83.6%)、风疹(82.9%)、乙型肝炎(81.4%)、水痘-带状疱疹(63.5%)、腮腺炎(45.4%)、麻疹(33.3%)。接种2剂疫苗后的血清阳性率为:甲型肝炎(98.8%)、水痘-带状疱疹(84.6%)、风疹(80%)、乙型肝炎(80%)、麻疹(32.2%)、腮腺炎(36.2%)。

结论

尽管接种了多剂疫苗,但儿童治疗后的血清学疫苗反应低于预期。鉴于可能需要定期进行血清学评估和加强接种,计划进行长期随访。

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