Measles and rubella antibody status in children after treatment for acute lymphoblastic leukemia

OBJETIVO: Avaliar a história vacinal e a situação da proteção vacinal contra sarampo e rubéola em crianças portadoras de leucemia linfóide aguda após o término do tratamento. MÉTODOS: O estado imunológico contra o sarampo e a rubéola foi avaliado pela técnica ELISA em 22 crianças com leucemia linfóide aguda após o término do tratamento. RESULTADOS: Dos 22 pacientes, 20 haviam recebido previamente duas doses da vacina do sarampo, e 18 deles, uma dose da vacina da rubéola. Soropositivos para sarampo e rubéola resultaram em 65 e 88,9 por cento, respectivamente, sem correlação com idade do paciente, agressividade do tratamento ou tempo decorrido entre final do tratamento e coleta da amostra. CONCLUSÃO: Detectamos falha na proteção vacinal contra sarampo e rubéola em 35 e 11,1 por cento dos casos, respectivamente. Recomendamos, ao final do tratamento para leucemia linfóide aguda, aplicar reforço da vacina contra sarampo, avaliar o estado imunológico contra rubéola e, se necessário, revacinar o paciente.

OBJECTIVE: To assess the vaccination history and the status of vaccine-induced protection from measles and rubella in children after treatment for acute lymphoblastic leukemia. METHODS: Measles and rubella immunological status was assessed by the ELISA technique for 22 children previously treated for acute lymphoblastic leukemia. RESULTS: From the total of 22 patients, 20 had been given two doses of measles vaccine and 18 had had one dose of rubella vaccine. The percentage of patients seropositive for measles and rubella were 65 and 88.9 percent, respectively, with no correlation with age of patient, aggression of treatment or the time passed between the end of treatment and sample collection. CONCLUSIONS: We detected that vaccination had failed against measles and rubella in 35 and 11.1 percent of cases, respectively. We recommend that a measles booster be given after the completion of treatment for acute lymphoblastic leukemia and that rubella immunity status should be assessed at this point, with revaccination performed when necessary.

Measles and rubella antibody status in children after treatment for acute lymphoblastic leukemia.

OBJECTIVE: To assess the vaccination history and the status of vaccine-induced protection from measles and rubella in children after treatment for acute lymphoblastic leukemia. METHODS: Measles and rubella immunological status was assessed by the ELISA technique for 22 children previously treated for acute lymphoblastic leukemia. RESULTS: From the total of 22 patients, 20 had been given two doses of measles vaccine and 18 had had one dose of rubella vaccine. The percentage of patients seropositive for measles and rubella were 65 and 88.9%, respectively, with no correlation with age of patient, aggression of treatment or the time passed between the end of treatment and sample collection. CONCLUSIONS: We detected that vaccination had failed against measles and rubella in 35 and 11.1% of cases, respectively. We recommend that a measles booster be given after the completion of treatment for acute lymphoblastic leukemia and that rubella immunity status should be assessed at this point, with revaccination performed when necessary.

Ulcerated rhabdomyosarcoma as portal of entry for tetanus in a previously nonimmunized child.

Infectious diseases represent one of the most important secondary problems related to the treatment of childhood cancer, being the leading cause of death in this population. They are predominantly of bacterial and fungal etiology. The association between tetanus, a bacterial vaccine-preventable disease, and cancer is virtually undescribed. The authors present the case of a previously nonimmunized child, due to his parents' choice, who developed severe tetanus with an ulcerated rhabdomyosarcoma as portal of entry. Due to an unfavorable evolution, the child underwent a hip disarticulation to provide tetanus control. The ulterior tumor management was successful: the child has been off therapy for more than 108 months with no evidence of disease.