Active immunization of children with leukemia and other malignancies

Derry Ridgway, Lawrence Wolff

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Active immunization against measles, Haemophilus influenza B, tetanus, diphtheria, hepatitis B, influenza, poliomyelitis, and, when indicated varicella and pneumococcus induces long-lasting immunologic protection in most healthy pediatric vaccine recipients. Among children receiving immunosuppressive therapy for cancer, possible early loss of specific immunity acquired from prior vaccination or disease, and likely diminished responsiveness to initial or booster vaccination must be considered. In addition, the safety of vaccine administration requires separate study in this population. Published evidence demonstrates preservation of vaccine-induced antibody titers against tetanus, diphtheria, poliomyelitis and (in children treated for lymphoma) pneumococcus. In contrast, prior immunity to varicella, influenza, and hepatitis B (when naturally acquired), and measles (acquired by vaccination) is compromised during and/or after antineoplastic therapy. Studies of immunologic protection acquired by prior vaccination against hepatitis B, varicella, and H influenza have not been published. The safety of administering toxoids and inactivated vaccines in this population is well documented. In contrast, morbidity must be expected if live attenuated vaccines (oral polio vaccine, attenuated measles vaccine or attenuated varicella vaccine) are administered to children receiving anti-cancer therapy. The risks of using live vaccines should be measured against demonstrable benefits in any vaccine program. The response to initial or booster immunizations against tetanus and diphtheria are similar to those in healthy children. For all other immunizations reviewed, responsiveness is diminished during periods of chemotherapy, more strikingly in children treated for leukemia than for solid tumors. Antibody responses to these vaccines range from slightly blunted (in the case of H influenza B) to marginal (influenza) or completely useless (pneumococcus and hepatitis B in children treated for leukemia).

Original languageEnglish (US)
Pages (from-to)177-192
Number of pages16
JournalLeukemia and Lymphoma
Volume9
Issue number3
DOIs
StatePublished - 1993

Fingerprint

Leukemia
Vaccination
Vaccines
Human Influenza
Hepatitis B
Attenuated Vaccines
Diphtheria
Chickenpox
Tetanus
Poliomyelitis
Streptococcus pneumoniae
Neoplasms
Measles
Chickenpox Vaccine
Toxoids
Measles Vaccine
Safety
Secondary Immunization
Inactivated Vaccines
Haemophilus influenzae

Keywords

  • Active immunization
  • Children
  • Leukemia
  • Malignancies

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Active immunization of children with leukemia and other malignancies. / Ridgway, Derry; Wolff, Lawrence.

In: Leukemia and Lymphoma, Vol. 9, No. 3, 1993, p. 177-192.

Research output: Contribution to journalArticle

Ridgway, Derry ; Wolff, Lawrence. / Active immunization of children with leukemia and other malignancies. In: Leukemia and Lymphoma. 1993 ; Vol. 9, No. 3. pp. 177-192.
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