Dwindled serum IgG levels of Rubella, Diphtheria toxin, Hepatitis B virus (HBV) and Tetanus Toxoid after chemotherapy; a report from Iranian children with malignancy
نویسندگان: Kazem Ghaffari ©, Abdorrahim Absalan , parnia iravani, Simin Sarlak, Roghayeh Rahimi Afzal , Aygin Eghbali , Aziz Eghbali
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Background and Aim
Chemotherapy suppresses immunoglobulin production as a result of cell toxicity. Decreased immunoglobulin levels can result in the onset of opportunistic infections. The aim of the current study is to compare the immunoglobulin G (IgG) levels of the selected vaccine-preventable disease (VPD) before and six months after chemotherapy in a group of Iranian children with malignancies.
In this interventional study, serum levels of Rubella, Diphtheria toxin, Hepatitis B virus (HBV), Tetanus Toxoid, Mumps, and Measles IgG were measured in 30 children with malignancy and previously vaccinated for these diseases. Six months after chemotherapy, serum IgG levels were reassessed and compared with their corresponding pre-chemotherapy levels.
In this study, 17 (56.7%) male and 13 (43.3%) female were included. The mean age was 7.69±3.09 years. After chemotherapy, Rubella IgG levels dropped from 73.88±85.11 to 56.59±72.84 IU/mL (P less than 0.05; r= 0.956; 33.4% become serum negative (SN)). Diphtheria toxin IgG was diminished from 0.683±0.454 to 0.174±0.248 IU/mL (P less than 0.05; r=0.601; 26.7% SN). Anti -HBV IgG showed a reduction from 46.26±101.56 to 25.56±80.49 IU/mL (p less than 0.05; r= 0.524; 60% SN) and Anti -Tetanus Toxoid IgG fell down from 1.031±0.582 to 0.321±0.408 IU/mL (p less than 0.05; r= 0.365; 33.4% SN). Anti -Measles and Anti -Mumps IgGs showed no significant change (p greater than 0.05).
Pediatric chemotherapy was associated with dropped serum IgG levels of most VPDs. A good correlation was also observed between serum levels of IgG before and six months after chemotherapy. Revaccination of children with malignancies may be necessary upon declined serum IgG titers.
Chemotherapy; Immunoglulin G; Neoplasm; Vaccine-preventable diseases
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