Akademik Veri Yönetim Sistemi
Turkish Journal of Immunology, cilt.10, sa.1, ss.19-22, 2005 (SCI-Expanded, ESCI, Scopus)
Children with leukemia and solid tumors are at high risk of developing hepatitis B infection. The rate was reported to be as high as 83-87% in Turkey about 10-20 years ago. Previous studies demonstrated impaired immune response to vaccination during intensive chemotherapy. Therefore, in our study, children were vaccinated after completing the intensive chemotherapy period to achieve a better immune response. Patients received BFM-95 protocol for acute lymphoblastic leukemia (ALL). Fourty three (34 boys, 9 girls; mean 5 years old) children were investigated retrospectively. The vaccination schedule began at the sixth month of maintenance therapy with recombinant HBV vaccine ( Gen-Hevac Pasteur) and was continued at months 1 and 6 thereafter. All patients were screened for HBV at diagnosis and prior to immunization by testing HBsAg, antiHBs, HBeAg, antiHBe Ag, anti-HBclgM and anti-HBclgG. An assay for the presence of anti-HBs was carried out 2 months after the administration of the third dose and if antiHBs titer was below 10 mlU/ml, a fourth dose was given. There were seven children with seronegative serology at the diagnosis and after intensive therapy. None of the patients became seropositive during the therapy. A total of 29 children were vaccinated of whom 10 (34 %) didn.t develop sufficient anti-HBs titer. Interestingly, 5 children who were seropositive became seronegative after intensive chemotherapy, although 8 children continued to have significant antiHBS titers. The antibody titers of these children were not higher than the others at the time of diagnosis. The data reveal that children who will receive anticancer chemotherapy should be screened for HBV and vaccinated during intensive chemotherapy and thereafter.