血液癌症治疗后儿童的疫苗免疫:一个回顾性单中心研究
Melissa Cetin1, Fabienne Gumy-Pause2,3, Renato Gualtieri4
1Geneva University Hospitals, Faculty of Medicine.
Journal of pediatric hematology/oncology
|November 3, 2023
概括
接受化疗的儿童失去疫苗免疫力,面临可预防疾病的风险. 结构化的再接种计划对于在治疗后保持对肺炎球菌和乙型肝炎等感染的保护至关重要.
科学领域:
- 儿科瘤学 儿科瘤学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 用化疗治疗的儿童经历了疫苗诱导免疫力的减弱.
- 这种保护的丧失增加了治疗后对疫苗可以预防的疾病的脆弱性.
- 目前的再接种指南不一致,导致治疗后免疫接种存在差距.
研究的目的:
- 在化疗前后评估血液癌症儿童的疫苗免疫力.
- 评估机构再接种计划的遵守和有效性.
- 为优化癌症后疫苗接种策略提供信息.
主要方法:
- 在2015年4月至2021年7月期间,对31名患有血液癌症的儿童进行了回顾性研究.
- 对喉炎,破伤风,肺炎链球菌,b型流感血红球菌 (Hib),麻疹,水和乙型肝炎的血清抗体水平的分析.
- 在化疗前,期间和之后评估疫苗接种时间和血清保护.
主要成果:
- 化疗后对多种疫苗的保护显著下降,特别是肺炎球菌 (27-33%),白喉病 (27-33%),B型肝炎 (40%).
- 在治疗后没有系统地进行再接种疫苗.
- 在治疗后的第一年,许多儿童仍然没有受到肺炎球菌,麻疹,乙型肝炎和腹膜炎的保护.
结论:
- 个性化,血清学引导的疫苗接种计划对于癌症后护理至关重要.
- 定期的血清学追踪和随访是必要的,以确定是否需要强剂.
- 建议包括基于免疫状况的联合疫苗和组合疫苗的特定疫苗接种计划.
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