Adequate immune responses to vaccines after chemotherapy for leukaemia diagnosed in childhood

Aim The survival rate after treatment for childhood leukaemia has greatly improved, but could result in protracted immune deficiency. This study examined the immune status of children after chemotherapy and evaluated their responses to immunisation. Methods Subjects who had completed their treatment...

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Bibliographic Details
Published in:Acta Paediatrica 2024-03, Vol.113 (3), p.606-614
Main Authors: Óskarsson, Ýmir, Thors, Valtýr, Vias, Rafael Daníel, Lúðvíksson, Björn Rúnar, Brynjólfsson, Siggeir Fannar, Gianchecchi, Elena, Razzano, Ilaria, Montomoli, Emanuele, Gísli Jónsson, Ólafur, Haraldsson, Ásgeir
Format: Article
Language:English
Subjects:
Acute lymphoblastic leukemia
Chemotherapy
Child
childhood cancer
Children
Hemagglutination inhibition
Humans
Immune response
Immune status
Immunity
Immunization
Influenza
Influenza Vaccines - therapeutic use
Influenza, Human - drug therapy
Influenza, Human - prevention & control
leukaemia
Leukemia
Lymphocytes
Male
Patients
Pneumococcal Vaccines - therapeutic use
Streptococcus infections
Streptococcus pneumoniae
Vaccination
Vaccines
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Summary:Aim The survival rate after treatment for childhood leukaemia has greatly improved, but could result in protracted immune deficiency. This study examined the immune status of children after chemotherapy and evaluated their responses to immunisation. Methods Subjects who had completed their treatment for acute lymphoblastic leukaemia at The Children's Hospital Reykjavík, Iceland, during 2011–2020 had blood drawn and were then immunised for influenza in October 2021. Blood was drawn again 4 weeks later and their humoral and cellular responses were measured with a haemagglutination inhibition assay and lymphocyte stimulation test. Antibodies to other immunisations were also evaluated. Results We studied 18 patients (10 male) who had completed their treatment at 3.7–20.3 years of age (mean 9.1), 11–84 months (mean 36.9) before enrolment. Conventional immunological evaluation did not reveal notable abnormalities. The responses to several childhood vaccinations, including the pneumococcal conjugate vaccination, were adequate in most patients. Humoral responses to the influenza vaccine confirmed adequate reactions in all but one patient. Considerable variations were observed in the lymphocyte stimulations tests. Conclusion Most patients reacted adequately to immunisation, especially against annual influenza and Streptococcus pneumoniae, reiterating the usefulness of vaccinations. The most appropriate timing for vaccination after treatment still needs to be determined.
ISSN:0803-5253
1651-2227
1651-2227
DOI:10.1111/apa.17070