Hepatitis B vaccination and immune response in children with malignant disease

ABSTRACT

Forty children with malignant disease were vaccinated by hepatitis B vaccine [recombinant]. Twenty children suffered of acute lymphoblastic leukemia [ALL] [Group I] and twenty patients with various forms of solid tumours [Group II]. The malignant patients were compared to twenty normal controls [Group III]. To evaluate the immune response we determined the antibody titres [Anti HBs] at Month 1, Month 2, Month 6, Month 7 from the first vaccination. At month 7 [1 month after the third vaccination dose] only 5 out of 20 in Group I seroconverted with a mean anti HBs of 16.6 mIU/ml, 10 out of 20 in Group II seroconverted with a mean anti HBs of 45.8 mIU/ml. In contrast in the control group, 19 out of 20 [95 percent], a full response was obtained with a mean antibody titre [Anti HBs of 460.4 mIU/ml]. We recommend that Children with acute lymphoblastic leukemia when necessary should be protected by passive immunisation against Hepatitis B as they have a markedly impaired immune response. While an early vaccination of patients suffering from solid tumours before the start of chemotherapy followed also by passive immunisation by injecting anti HBs immunoglobulin when indicated