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[Vaccination against hepatitis B in children with chronic hematologic diseases treated with immunosuppression]

T Jackowska1, R Rokicka-Milewska, K Madaliński

  • 1Katedra i Klinika Pediatrii, Hematologii i Onkologii Akademii Medycznej w Warszawie.

Przeglad Epidemiologiczny
|January 1, 1997
PubMed

Insights

Vaccinating children against hepatitis B during early cancer treatment effectively builds immunity. Protective antibody levels persist for six years, but a shortened vaccine schedule proved ineffective for these patients.

Area of Science:

  • Immunology
  • Pediatric Oncology
  • Vaccinology

Background:

  • Hepatitis B infection poses risks in managing pediatric cancer and aplastic anemia.
  • Effective hepatitis B prevention is crucial for immunocompromised children undergoing cancer therapy.

Purpose of the Study:

  • To evaluate the efficacy of active immunization with hepatitis B vaccine (Engerix B) in children with various cancers.
  • To determine the duration of protective antibody levels post-vaccination.
  • To compare the effectiveness of standard versus shortened vaccination schedules.

Main Methods:

  • Children with Hodgkin's disease, solid tumors, and leukemia received hepatitis B vaccination (Engerix B).
  • Vaccination timing varied: during early immunosuppressive therapy for solid tumors/Hodgkin's, and post-therapy for leukemia.
  • Antibody levels were monitored for seroconversion and long-term protection.
  • A subset received a shortened vaccination schedule (0-10-20 days).

Main Results:

  • Children with Hodgkin's disease and solid tumors responded well to vaccination during early immunosuppressive therapy.
  • Leukemia patients achieved effective immunization after completing immunosuppressive therapy.
  • Protective antibody levels were maintained for at least 6 years post-vaccination.
  • The shortened vaccination schedule (0-10-20 days) was ineffective in this pediatric cohort.
  • Immune disorders were identified as a cause for lack of seroconversion in 6 children.

Conclusions:

  • Active immunization with hepatitis B vaccine is effective in pediatric cancer patients, with optimal timing depending on the specific condition and therapy.
  • Long-term protection is achievable, highlighting the importance of timely vaccination.
  • Standard vaccination schedules are recommended over shortened ones for immunocompromised children.
  • Passive immunization is advised for children with chronic neoplastic hematological diseases during immunosuppression.

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