J Korean Med Sci.  2012 Jan;27(1):78-83. 10.3346/jkms.2012.27.1.78.

Assessment of Serologic Immunity to Diphtheria-Tetanus-Pertussis After Treatment of Korean Pediatric Hematology and Oncology Patients

• Kwon HJ
• Lee JW
• Chung NG
• Cho B
• Kim HK
• Kang JH

• KMID: 1792983
• DOI: http://doi.org/10.3346/jkms.2012.27.1.78

Abstract

The aim of this study was to investigate the diphtheria-tetanus-pertussis antibody titers after antineoplastic treatment and to suggest an appropriate vaccination approach for pediatric hemato-oncologic patients. A total of 146 children with either malignancy in remission after cessation of therapy or bone marrow failure were recruited. All children had received routine immunization including diphtheria-tetanus-acellular pertussis vaccination before diagnosis of cancer. The serologic immunity to diphtheria, tetanus and pertussis was classified as: completely protective, partially protective, or non-protective. Non-protective serum antibody titer for diphtheria, tetanus and pertussis was detected in 6.2%, 11.6%, and 62.3% of patients, respectively, and partial protective serum antibody titer for diphtheria, tetanus and pertussis was seen in 37%, 28.1%, and 8.9% of patients. There was no significant correlation between the severity of immune defect and age, gender or underlying disease. Revaccination after antineoplastic therapy showed significantly higher levels of antibody for each vaccine antigen. Our data indicates that a large proportion of children lacked protective serum concentrations of antibodies against diphtheria, tetanus, and pertussis. This suggests that reimmunization of these patients is necessary after completion of antineoplastic treatment. Also, prospective studies should be undertaken with the aim of devising a common strategy of revaccination.

Keyword

Serologic Immunity; Immunocompromised Children; Diphtheria; Tetanus; Pertussis; Vaccination

MeSH Terms

Adolescent
Age Factors
Antibodies, Bacterial/blood/immunology
Antineoplastic Agents/therapeutic use
Child
Child, Preschool
Diphtheria/immunology/prevention & control
Diphtheria-Tetanus-acellular Pertussis Vaccines/*immunology
Female
Hematologic Neoplasms/*diagnosis/drug therapy
Humans
Immunization, Secondary
Lymphoma/diagnosis/drug therapy
Male
Neuroblastoma/diagnosis/drug therapy
Sex Factors
Tetanus/immunology/prevention & control
Whooping Cough/immunology/prevention & control