Impact of conventional chemotherapy on levels of antibodies against vaccine-preventable diseases in children treated for cancer

Scand J Infect Dis. 2003;35(11-12):851-7. doi: 10.1080/00365540310016600.


Intensive chemotherapy in children with malignancies causes partial immune deficiency, including long-term impairment of humoral immunity. We investigated the levels of antibodies against measles, mumps, polio, rubella, diphtheria, tetanus, and Haemophilus type b (Hib) in 139 children at the time of diagnosis of the malignant disease, during chemotherapy, after cessation of intensive treatment, and after re-vaccination. In general, cytostatic therapy resulted in a significant lowering of antibody levels. A decline of antibodies below the protective level as a consequence of cytostatic treatment was observed in 6% of the children for measles and mumps, in 18%, 12%, and 25% for polio types 1, 2, and 3, and in 21% for diphtheria. By contrast, rubella and tetanus antibodies remained within the protective range in all cases of this study. Re-vaccination 3 to 5 months after cessation of chemotherapy produced antibody levels about as high as those measured prior to therapy. Only 6 out of 83 children with previously positive antigen titres did not respond to re-vaccination. Vaccination or re-vaccination failed in 5 of 13 non-responders for more than 1 antigen, indicating a decreased reactability to vaccinations in some patients.

MeSH terms

  • Adolescent
  • Analysis of Variance
  • Antibodies, Viral / analysis*
  • Antibody Formation / immunology
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Cohort Studies
  • Communicable Disease Control
  • Communicable Diseases / immunology*
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Humans
  • Immunity
  • Immunization Schedule
  • Immunization, Secondary
  • Immunocompromised Host
  • Infant
  • Male
  • Neoplasms / drug therapy*
  • Neoplasms / immunology*
  • Neoplasms / pathology
  • Reference Values
  • Risk Assessment
  • Sensitivity and Specificity
  • Statistics, Nonparametric


  • Antibodies, Viral