Measles, Mumps, Varicella Zoster, Diphtheria and Hepatitis B Surface Antibody Status in Pediatric Acute Leukemic Patients

Background and Aim: This is a preliminary study to evaluate the levels of protective antibodies against some of the vaccine preventable diseases, as a part of the nationwide vaccination program, in Acute Lymphocytic Leukemic children (ALL) and in their non cancer controls of matched age and sex. Methods: Serum antibody levels of measles, mumps, Varicella zoster, diphtheria, and hepatitis B surface antigen were evaluated by ELISA technique in 120 children with ALL as well as in 60 children with no malignancy as a control group. Results: A protective serum antibody level to measles, mumps, Varicella zoster, diphtheria and hepatitis B were detected in 53%, 14%, 38%, 83% and 72%, respectively of leukemic children irrelevant to phase of treatment compared to 53%, 20%, 40%, 75% and 67%, in the controls. Seropositivity rate of diphtheria was not found to be related to age in both ALL patients and controls. A significant decline in seropositivity rate to antiHBs with age in both leukemic and their controls was observed (p=0.02, 0.015 respectively). On multivariate analysis, seropositivity of varicella and mumps was positively dependent on age (P<0.001, 0.03, respectively) and seropositivity of Hepatitis B virus significantly decreased with age (P=0.005). Conclusion: High percentages of acute leukemic patients and their controls were unprotected against measles, mumps and Varicella zoster. Immunogenicity of measles and mumps components in MMR should be re-evaluated. Booster dose of HB vaccine should be given to school aged children. Revaccination must be a task in treating leukemic patients at National Cancer Institute in Egypt.