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Antibody levels against tetanus and diphtheria after polychemotherapy for childhood sarcoma: a report from the Late Effects Surveillance System |
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| Authors: | Paulides Marios Stöhr Wolfgang Laws Hans-Jürgen Graf Norbert Lakomek Max Berthold Frank Schmitt Klaus Niggli Felix Jürgens Heribert Bielack Stefan Koscielniak Ewa Klingebiel Thomas Langer Thorsten |
| Affiliation: | a LESS Centre, University Hospital for Children and Adolescents, Department for Paediatric Oncology and Immunology, Loschgestrasse 15, 91054 Erlangen, Germany b University Hospital for Paediatric Oncology, Haematology and Immunology, Düsseldorf, Germany c University Hospital for Paediatric Oncology and Haematology, Homburg, Saar, Germany d University Department for Paediatrics I, Centre for Childhood and Adolescent Medicine, Göttingen, Germany e University Hospital for Paediatric Oncology and Haematology, Köln, Germany f Childrens’ Hospital, Linz, Austria g University Childrens’ Hospital, Zürich, Switzerland h Ewing's Sarcoma Trial Centre, University Children's Hospital Muenster, Department of Paediatric Haematology and Oncology, Muenster, Germany i Cooperative Osteosarcoma Study Group, Olgahospital, Paediatrics 5 (Oncology, Haematology, Immunology), Stuttgart, Germany j Cooperative Soft Tissue Sarcoma Study, Olgahospital, Paediatrics 5 (Oncology, Haematology, Immunology), Stuttgart, Germany k Cooperative Soft Tissue Sarcoma Study, Klinik für Kinderheilkunde III (Paediatric Haematology, Oncology and Haemostaseology), Klinikum der Johann-Wolfgang-Goethe-Universität Frankfurt, Germany |
| Abstract: | BackgroundIt is known that antineoplastic treatment may induce secondary immunodeficiency, but studies after childhood sarcoma are rare. Since 1998, the Late Effects Surveillance System (LESS) of the German Society for Paediatric Oncology and Haematology (GPOH) prospectively registers late effects in soft tissue-, osteo- and Ewing's sarcoma patients treated within the therapy trials EICESS-92/EURO-E.W.I.N.G.-99, CWS-96/CWS-2002P, COSS-96 in Austria, Germany and Switzerland.Patients and methodsAntibody levels (AL) against diphtheria and tetanus were used as markers for immunity and classified according to established guidelines for protective AL values. There were 47 eligible relapse-free patients < 21 years of age (31 males; 10 osteosarcoma, 12 Ewing's and 25 soft tissue sarcoma patients). Median age at diagnosis was 9.6 (interquartile range: 4.4-14.7) years.ResultsA median 7.2 (3.7-12.2) months after end of antineoplastic therapy, in 28% (13/47; 95% CI 16-43%) of patients there were no protective AL (<0.1 IU/ml) against diphtheria and/or tetanus. Diphtheria and tetanus AL were positively correlated (r = 0.39; p = 0.007). In multivariable analysis, the type of treatment had no effect on AL, similar to tumour type and time of examination after treatment end. Younger patients had significantly lower AL against tetanus (p = 0.009) and girls had significantly lower AL against diphtheria than boys (p = 0.015).ConclusionLack of protective AL against tetanus and/or diphtheria is frequent after childhood sarcoma treatment. Prospective surveillance of immunity and, if indicated, re-immunization is warranted in patients treated for childhood cancer. |
| Keywords: | Vaccine Tetanus Diphtheria Cancer Children |
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