Rituximab and protection from vaccine preventable diseases: applying the evidence to pediatric patients.
Expert Rev Vaccines
; 15(12): 1567-1574, 2016 12.
Article
em En
| MEDLINE
| ID: mdl-27216827
INTRODUCTION: This article analyses and highlights the challenge of immunization and preventing vaccine preventable diseases in pediatric patients on rituximab. Rituximab is a chimeric anti-CD 20 monoclonal antibody that is an immunosuppressant affecting both cellular and humoral immunity. Children and adolescents on rituximab are at increased risk of infection and vaccine preventable diseases, and require additional strategies to optimize and maximize their protection against such illnesses. Areas covered: This article provides a comprehensive MEDLINE and Pubmed review of existing literature regarding vaccine immunogenicity and safety in patients on rituximab, and assists in providing an evidence base to develop immunization guidelines. Of particular note, the use of live-attenuated vaccines and optimum timing of vaccines post rituximab is considered and discussed. Expert commentary: The increasing use of rituximab in a variety of novel areas within pediatrics must be accompanied by informed discussion around mitigating the risks. These include immunosuppression, and potential susceptibility to infection. Optimizing vaccine status by establishing adequate antibody titers prior to commencement remains the best preventative strategy.
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Base de dados:
MEDLINE
Assunto principal:
Infecções Oportunistas
/
Vacinas
/
Doenças Transmissíveis
/
Rituximab
/
Imunossupressores
Tipo de estudo:
Qualitative_research
Limite:
Humans
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article