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measles,mumps,and rubella revaccination in children after completion of chemotherapy and hematopoietic stem cell transplantation:a single-center prospective efficacy and safety analysis

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World Journal of Pediatrics 2023年第11期19卷 1062-1070页

作者： Min Wang Qing Yuan Peng-Fei Deng Yi Fei Hua Zhang Fen Zhou Wen-Juan Chen Qing Cao Jing Chen Yi-Jin Gao Department of Hematology and Oncology Shanghai Children’s Medical CenterSchool of MedicineShanghai Jiao Tong UniversityNo.1678 Dongfang RoadPudong DistrictShanghai200127China Center for Diseases Control and Prevention Fudan University Pudong Institute of Preventive MedicineShanghai200136China Department of Infectious Diseases Shanghai Children’s Medical CenterShanghai Jiao Tong University School of MedicineShanghaiChina

Background Chemotherapy and hematopoietic stem cell transplantation(HSCT)can damage the immune system,and may result in a loss of protection from infectious diseases.This study aimed to evaluate the impact of these treatments on the decrease in antibody titers of the measles,mumps,and rubella(MMR)vaccine and seroconversion post-revaccination of MMR.Methods After completion of treatment for primary diseases,participants received an MMR revaccination.Antibody titers for MMR before revaccination were analyzed for all 110 children.After revaccination,68 participants received a follow-up evaluation of antibody titer and adverse reaction.Results Multivariable analysis showed that therapeutic schedules were the only factor correlated with lack of antibody titers for measles after completing treatment(P=0.008),while for mumps and rubella,no statistically significant difference was observed.Importantly,our study clearly demonstrated positive seroconversion rates for measles(97.5%),mumps(81.0%),and rubella(93.2%),with antibody levels rising across the board and peaking at around 6 months following revaccination.However,6 months after revaccination,a downtrend of antibody titer levels was observed,which is comparatively earlier than the waning immunity observed in healthy children.Furthermore,we found MMR revaccination to be safe,with only a single adverse reaction(local pain at the injection site)reported.Conclusions MMR revaccination is immunogenic for the population.We suggest periodic monitoring of antibody titers,in addition to a booster vaccination,although the optimal timing of booster vaccination remains to be investigated further.

关键词： Adjuvant Chemotherapy Children Hematopoietic stem cell transplantation Immunogenicity mumps-measles-rubella.vaccine

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