Immune response of immunocompromised children with malignancies to a recombinant hepatitis B vaccine

Pediatr Hematol Oncol. Sep-Oct 1996;13(5):425-31. doi: 10.3109/08880019609030854.

Abstract

The aim of this study was to interpret the antibody response to hepatitis B vaccination following an intensified four-dose schedule in 140 cancer patients who presented at our clinic between January 1, 1993 and December 31, 1994. According to therapy status, the patients were divided into two groups: group A consisted of 76 patients undergoing chemotherapy and group B of 64 patients in complete remission and off treatment. The eligibility requirements were negative hepatitis B virus (HBV), HCV, and human immunodeficiency virus serologic markers. A total of four dose (20 micrograms per dose) of recombinant HB vaccine was administered intramuscularly in the deltoid region at 0, 1, 2, and 6 months. Blood from the vaccinated subjects was obtained at months 1, 2, 3, and 7 in order to measure anti-HBs titer levels. Protective anti-HBs titers were considered to be those > or = 10 mIU/mL. The overall seroconversion rate 1 month after the fourth dose was 57% (80/140 patients), and the seroconversion rates for groups A and B were 31.5% (24/76 patients) and 87.5% (56/64 patients), respectively. Our results indicated that immunocompromised children undergoing chemotherapy (although less responsive than children in complete remission and off treatment) still preserved their potential to produce protective titers of anti-HBs. On this basis we recommend (1) HB vaccination after diagnosis of malignancy in pediatric patients whenever a high prevalence of HB infection exists and (2) vaccination of patients of therapy and in complete remission.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use
  • Child
  • Child, Preschool
  • Female
  • Greece / epidemiology
  • Hematologic Neoplasms / drug therapy
  • Hematologic Neoplasms / immunology
  • Hepatitis B / epidemiology
  • Hepatitis B / prevention & control*
  • Hepatitis B Antibodies / biosynthesis*
  • Hepatitis B Surface Antigens / immunology*
  • Hepatitis B Vaccines / immunology*
  • Hepatitis B virus / immunology*
  • Humans
  • Immunocompromised Host
  • Infant
  • Male
  • Neoplasms / drug therapy
  • Neoplasms / immunology*
  • Prevalence
  • Remission Induction
  • Transfusion Reaction
  • Vaccination*
  • Vaccines, Synthetic / immunology*

Substances

  • Antineoplastic Agents
  • Hepatitis B Antibodies
  • Hepatitis B Surface Antigens
  • Hepatitis B Vaccines
  • Vaccines, Synthetic