Immune response to hepatitis B vaccination in children with cancer
Keywords:
Hepatitis B, vaccines, child, neoplasmsAbstract
Introduction: Colombia is an endemic country for hepatitis B (HB) virus infection. At the Nacional Cancer Institute a large number of cancer-surviving children are infected with HB virus. Accordingly, all patients under 18 years underwent vaccination against HB infection.
Objectives: evaluate the immune response to HB vaccination in patients under chemotherapy treatment and the protection level after each vaccination dose. Compare the efficacy of the HB vacccine in patients with leukemia and lymphoma (group 1) and with solid tumors (group 2).
Materials and methods: Eighty patients with cancer diagnosis and HB negative serology were recruited between April 1996 and April 1997. All patients received a 3 - dose recombinant vaccination every 30 days, as follows: children under 20 µg, 20 kg, and children over 20 kg, 40 µg. Seroconvertion (any increase of antibody titers) and protection (antibody level over 10 mUI/ml) were analyzed from blood samples at cancer diagnostic, before each vaccination dose, and one month after the last dose.
Results: The efficacy was 17%, 34%, and 38% after 1st, 2nd, and 3th dose, respectively. Out of 37 patients in group 1, 12 (32%) obtained protection, while 18/43 patients (41%) in group 2 reached protective titers. There was not a significant difference between the two groups (p= 0.338).
Conclusion: Children with cancer under chemotherapy show an impaired immune response to HB vaccination. These results are still unsatisfactory, but we expect to improve them by intensifying the vaccination scheme in the future.
Author Biographies
Amaranto Suárez, Instituto Nacional de Cancerología de Colombia
Servicio de Oncología Pediátrica, INC
Gretti Terselich, Instituto Nacional de Cancerología de Colombia
Laboratorio Banco de Sangre, INC
Lucía del Pilar Cortés, Instituto Nacional de Cancerología de Colombia
Laboratorio Banco de Sangre, INC
Teresa Martínez, Instituto Nacional de Cancerología de Colombia
Grupo de Investigación Clínica, INC
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