Vaccinations in Children Treated with Standard-Dose Cancer Therapy or Hematopoietic Stem Cell Transplantation

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Most children with cancer are immunocompromised during therapy and for a variable period after completion of therapy. They are at an increased risk of infections, including vaccine-preventable infections. There is a reduction in immunity to vaccine-preventable diseases after completion of standard-dose chemotherapy and after hematopoietic stem cell transplant. It is important to protect these children against vaccine-preventable diseases by reimmunization.

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Vaccinations in children treated with standard-dose chemotherapy

Children treated with standard-dose chemotherapy are at increased risk of infection. However, there are few data on the precise incidence of specific infections in this population. With regard to vaccine-preventable disease, there are data demonstrating an increase in incidence and severity of Haemophilus influenzae type b (Hib), pneumococcal, measles, and varicella infections [1], [2], [3], [4].

Vaccinations in hematopoietic stem cell transplant recipients

In recent years HSCT has become increasingly used to allow the administration of potentially curative high-dose chemotherapy and radiotherapy to patients with hematologic and nonhematologic malignancies. HSCT is classified as either allogeneic or autologous. Allogeneic HSCT is the infusion of hematopoeitic stem cells (HSC) from a donor to a patient. Autologous HSCT is the reinfusion of the patient's own HSC. HSCT procedures vary; the source of HSC cells can be bone marrow, umbilical cord blood,

Summary

Children are immunosuppressed after completion of standard dose chemotherapy and after HSCT. They are at increased risk of infections, including vaccine-preventable infections. Revaccination is therefore important. After completion of standard dose chemotherapy, children should receive one dose of each childhood vaccine as per the immunization schedule of their country of residence.

HSCT recipients have extensive immune alterations and are particularly susceptible to infection with

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