Skip to main content
Top
Published in: World Journal of Pediatrics 11/2023

23-04-2023 | Mumps | Original Article

Measles, mumps, and rubella revaccination in children after completion of chemotherapy and hematopoietic stem cell transplantation: a single-center prospective efficacy and safety analysis

Authors: Min Wang, Qing Yuan, Peng-Fei Deng, Yi Fei, Hua Zhang, Fen Zhou, Wen-Juan Chen, Qing Cao, Jing Chen, Yi-Jin Gao

Published in: World Journal of Pediatrics | Issue 11/2023

Login to get access

Abstract

Background

Chemotherapy and hematopoietic stem cell transplantation (HSCT) can damage the immune system, and may result in a loss of protection from infectious diseases. This study aimed to evaluate the impact of these treatments on the decrease in antibody titers of the measles, mumps, and rubella (MMR) vaccine and seroconversion post-revaccination of MMR.

Methods

After completion of treatment for primary diseases, participants received an MMR revaccination. Antibody titers for MMR before revaccination were analyzed for all 110 children. After revaccination, 68 participants received a follow-up evaluation of  antibody titer and adverse reaction.

Results

Multivariable analysis showed that therapeutic schedules were the only factor correlated with lack of antibody titers for measles after completing treatment (P = 0.008), while for mumps and rubella, no statistically significant difference was observed. Importantly, our study clearly demonstrated positive seroconversion rates for measles (97.5%), mumps (81.0%), and rubella (93.2%), with antibody levels rising across the board and peaking at around 6 months following revaccination. However, 6 months after revaccination, a downtrend of antibody titer levels was observed, which is comparatively earlier than the waning immunity observed in healthy children. Furthermore, we found MMR revaccination to be safe, with only a single adverse reaction (local pain at the injection site) reported.

Conclusions

MMR revaccination is immunogenic for the population. We suggest periodic monitoring of antibody titers, in addition to a booster vaccination, although the optimal timing of booster vaccination remains to be investigated further.
Literature
1.
go back to reference Toft N, Birgens H, Abrahamsson J, Griskevicius L, Hallbook H, Heyman M, et al. Results of nopho all2008 treatment for patients aged 1–45 years with acute lymphoblastic leukemia. Leukemia. 2018;32:606–15.CrossRefPubMed Toft N, Birgens H, Abrahamsson J, Griskevicius L, Hallbook H, Heyman M, et al. Results of nopho all2008 treatment for patients aged 1–45 years with acute lymphoblastic leukemia. Leukemia. 2018;32:606–15.CrossRefPubMed
2.
go back to reference Mussolin L, Le Deley M-C, Carraro E, Damm-Welk C, Attarbaschi A, Williams D, et al. Prognostic factors in childhood anaplastic large cell lymphoma: long term results of the international alcl99 trial. Cancers. 2020;12:2747.CrossRefPubMedPubMedCentral Mussolin L, Le Deley M-C, Carraro E, Damm-Welk C, Attarbaschi A, Williams D, et al. Prognostic factors in childhood anaplastic large cell lymphoma: long term results of the international alcl99 trial. Cancers. 2020;12:2747.CrossRefPubMedPubMedCentral
3.
go back to reference Baronciani D, Angelucci E, Potschger U, Gaziev J, Yesilipek A, Zecca M, et al. Hemopoietic stem cell transplantation in thalassemia: a report from the european society for blood and bone marrow transplantation hemoglobinopathy registry, 2000–2010. Bone Marrow Transplant. 2016;51:536–41.CrossRefPubMed Baronciani D, Angelucci E, Potschger U, Gaziev J, Yesilipek A, Zecca M, et al. Hemopoietic stem cell transplantation in thalassemia: a report from the european society for blood and bone marrow transplantation hemoglobinopathy registry, 2000–2010. Bone Marrow Transplant. 2016;51:536–41.CrossRefPubMed
4.
go back to reference Miyamoto S, Yanagimachi M, Umeda K, Iguchi A, Sasahara Y, Takada H, et al. Hematopoietic stem cell transplantation for severe combined immunodeficiency in japan: a nationwide retrospective analysis. Bone Marrow Transplant. 2020;55:443–543. Miyamoto S, Yanagimachi M, Umeda K, Iguchi A, Sasahara Y, Takada H, et al. Hematopoietic stem cell transplantation for severe combined immunodeficiency in japan: a nationwide retrospective analysis. Bone Marrow Transplant. 2020;55:443–543.
5.
go back to reference Perkins JL, Harris A, Pozos TC. Immune dysfunction after completion of childhood leukemia therapy. J Pediatr Hematol Oncol. 2017;39:1–5.CrossRefPubMed Perkins JL, Harris A, Pozos TC. Immune dysfunction after completion of childhood leukemia therapy. J Pediatr Hematol Oncol. 2017;39:1–5.CrossRefPubMed
6.
go back to reference Friman V, Winqvist O, Blimark C, Langerbeins P, Chapel H, Dhalla F. Secondary immunodeficiency in lymphoproliferative malignancies. Hematol Oncol. 2016;34:121–32.CrossRefPubMed Friman V, Winqvist O, Blimark C, Langerbeins P, Chapel H, Dhalla F. Secondary immunodeficiency in lymphoproliferative malignancies. Hematol Oncol. 2016;34:121–32.CrossRefPubMed
7.
go back to reference Goswami M, Prince G, Biancotto A, Moir S, Kardava L, Santich BH, et al. Impaired b cell immunity in acute myeloid leukemia patients after chemotherapy. J Transl Med. 2017;15:155.CrossRefPubMedPubMedCentral Goswami M, Prince G, Biancotto A, Moir S, Kardava L, Santich BH, et al. Impaired b cell immunity in acute myeloid leukemia patients after chemotherapy. J Transl Med. 2017;15:155.CrossRefPubMedPubMedCentral
8.
go back to reference Garonzi C, Balter R, Tridello G, Pegoraro A, Pegoraro M, Pacenti M, et al. The impact of chemotherapy after pediatric malignancy on humoral immunity to vaccine-preventable diseases. Mediterr J Hematol Infect Dis. 2020;12:e2020014.CrossRefPubMedPubMedCentral Garonzi C, Balter R, Tridello G, Pegoraro A, Pegoraro M, Pacenti M, et al. The impact of chemotherapy after pediatric malignancy on humoral immunity to vaccine-preventable diseases. Mediterr J Hematol Infect Dis. 2020;12:e2020014.CrossRefPubMedPubMedCentral
9.
go back to reference Kuter BJ, Marshall GS, Fergie J, Schmidt E, Pawaskar M. Prevention of measles, mumps and rubella: 40 years of global experience with m-m-r-ii. Hum Vaccin Immunother. 2021;17:5372–83.CrossRefPubMed Kuter BJ, Marshall GS, Fergie J, Schmidt E, Pawaskar M. Prevention of measles, mumps and rubella: 40 years of global experience with m-m-r-ii. Hum Vaccin Immunother. 2021;17:5372–83.CrossRefPubMed
10.
go back to reference Measles vaccines. Who position paper—april 2017. Wkly Epidemiol Rec. 2017;92:205–27. Measles vaccines. Who position paper—april 2017. Wkly Epidemiol Rec. 2017;92:205–27.
11.
go back to reference Mumps virus vaccines. Wkly Epidemiol Rec. 2007;82:51–60. Mumps virus vaccines. Wkly Epidemiol Rec. 2007;82:51–60.
12.
go back to reference Progress in rubella and congenital rubella syndrome control and elimination—worldwide 2000–2016. Wkly Epidemiol Rec. 2017; 92:707–15. Progress in rubella and congenital rubella syndrome control and elimination—worldwide 2000–2016. Wkly Epidemiol Rec. 2017; 92:707–15.
13.
go back to reference Toret E, Yel SE, Suman M, Duzenli Kar Y, Ozdemir ZC, Dinleyici M, et al. Immunization status and re-immunization of childhood acute lymphoblastic leukemia survivors. Hum Vaccin Immunother. 2021;17:1132–5.CrossRefPubMed Toret E, Yel SE, Suman M, Duzenli Kar Y, Ozdemir ZC, Dinleyici M, et al. Immunization status and re-immunization of childhood acute lymphoblastic leukemia survivors. Hum Vaccin Immunother. 2021;17:1132–5.CrossRefPubMed
14.
go back to reference Kawamura K, Wada H, Nakasone H, Akahoshi Y, Kawamura S, Takeshita J, et al. Immunity and vaccination against measles, mumps, and rubella in adult allogeneic hematopoietic stem cell transplant recipients. Transplant Cell Ther. 2021;27:436.e1–e8.CrossRefPubMed Kawamura K, Wada H, Nakasone H, Akahoshi Y, Kawamura S, Takeshita J, et al. Immunity and vaccination against measles, mumps, and rubella in adult allogeneic hematopoietic stem cell transplant recipients. Transplant Cell Ther. 2021;27:436.e1–e8.CrossRefPubMed
15.
go back to reference Koochakzadeh L, Khosravi MH, Pourakbari B, Hosseinverdi S, Aghamohammadi A, Rezaei N. Assessment of immune response following immunization with dtp/td and mmr vaccines in children treated for acute lymphoblastic leukemia. Pediatr Hematol Oncol. 2014;31:656–63.CrossRefPubMed Koochakzadeh L, Khosravi MH, Pourakbari B, Hosseinverdi S, Aghamohammadi A, Rezaei N. Assessment of immune response following immunization with dtp/td and mmr vaccines in children treated for acute lymphoblastic leukemia. Pediatr Hematol Oncol. 2014;31:656–63.CrossRefPubMed
16.
go back to reference Bochennek K, Allwinn R, Langer R, Becker M, Keppler OT, Klingebiel T, et al. Differential loss of humoral immunity against measles, mumps, rubella and varicella-zoster virus in children treated for cancer. Vaccine. 2014;32:3357–61.CrossRefPubMed Bochennek K, Allwinn R, Langer R, Becker M, Keppler OT, Klingebiel T, et al. Differential loss of humoral immunity against measles, mumps, rubella and varicella-zoster virus in children treated for cancer. Vaccine. 2014;32:3357–61.CrossRefPubMed
17.
18.
go back to reference He HQ, Li Q, Yan R, Zhou Y, Tang XW, Deng X, et al. Antibody persistence following on different vaccination strategies of domestic measles, mumps and rubella combined attenuated live vaccine: a 3-year follow-up study. Zhonghua Yu Fang Yi Xue Za Zhi. 2017;51:336–40.PubMed He HQ, Li Q, Yan R, Zhou Y, Tang XW, Deng X, et al. Antibody persistence following on different vaccination strategies of domestic measles, mumps and rubella combined attenuated live vaccine: a 3-year follow-up study. Zhonghua Yu Fang Yi Xue Za Zhi. 2017;51:336–40.PubMed
19.
go back to reference Olkinuora H, Kayhty H, Davidkin I, Roivainen M, Olander R-M, Kantele JM, et al. Immunity after (re)vaccination of paediatric patients following haematopoietic stem cell transplantation. Acta Paediatr. 2012;101:e373–7.CrossRefPubMed Olkinuora H, Kayhty H, Davidkin I, Roivainen M, Olander R-M, Kantele JM, et al. Immunity after (re)vaccination of paediatric patients following haematopoietic stem cell transplantation. Acta Paediatr. 2012;101:e373–7.CrossRefPubMed
20.
go back to reference Patel SR, Ortin M, Cohen BJ, Borrow R, Irving D, Sheldon J, et al. Revaccination with measles, tetanus, poliovirus, haemophilus influenzae type b, meningococcus c, and pneumococcus vaccines in children after hematopoietic stem cell transplantation. Clin Infect Dis. 2007;44:625–34.CrossRefPubMed Patel SR, Ortin M, Cohen BJ, Borrow R, Irving D, Sheldon J, et al. Revaccination with measles, tetanus, poliovirus, haemophilus influenzae type b, meningococcus c, and pneumococcus vaccines in children after hematopoietic stem cell transplantation. Clin Infect Dis. 2007;44:625–34.CrossRefPubMed
21.
go back to reference Zignol M, Peracchi M, Tridello G, Pillon M, Fregonese F, D’elia R, et al. Assessment of humoral immunity to poliomyelitis, tetanus, hepatitis b, measles, rubella, and mumps in children after chemotherapy. Cancer. 2004;101:635–41.CrossRefPubMed Zignol M, Peracchi M, Tridello G, Pillon M, Fregonese F, D’elia R, et al. Assessment of humoral immunity to poliomyelitis, tetanus, hepatitis b, measles, rubella, and mumps in children after chemotherapy. Cancer. 2004;101:635–41.CrossRefPubMed
22.
go back to reference Yildirim ZK, Buyukavci M. Assessment of humoral immunity to hepatitis b, measles, rubella, and mumps in children after chemotherapy. J Pediatr Hematol Oncol. 2018;40:E99–102.CrossRef Yildirim ZK, Buyukavci M. Assessment of humoral immunity to hepatitis b, measles, rubella, and mumps in children after chemotherapy. J Pediatr Hematol Oncol. 2018;40:E99–102.CrossRef
23.
go back to reference Fouda AE, Kandil SM, Boujettif F, Salama YS, Fayea NY. Humoral immune response of childhood acute lymphoblastic leukemia survivors against the measles, mumps, and rubella vaccination. Hematology. 2018;23:590–5.CrossRefPubMed Fouda AE, Kandil SM, Boujettif F, Salama YS, Fayea NY. Humoral immune response of childhood acute lymphoblastic leukemia survivors against the measles, mumps, and rubella vaccination. Hematology. 2018;23:590–5.CrossRefPubMed
24.
go back to reference Viana SS, Araujo GS, Faro GBDA, Da Cruz-Silva LL, Araujo-Melo CA, Cipolotti R. Antibody responses to hepatitis b and measles-mumps-rubella vaccines in children who received chemotherapy for acute lymphoblastic leukemia. Rev Bras Hematol Hemoter. 2012;34:275–9.CrossRefPubMedPubMedCentral Viana SS, Araujo GS, Faro GBDA, Da Cruz-Silva LL, Araujo-Melo CA, Cipolotti R. Antibody responses to hepatitis b and measles-mumps-rubella vaccines in children who received chemotherapy for acute lymphoblastic leukemia. Rev Bras Hematol Hemoter. 2012;34:275–9.CrossRefPubMedPubMedCentral
25.
go back to reference Ek T, Josefson M, Abrahamsson J. Multivariate analysis of the relation between immune dysfunction and treatment intensity in children with acute lymphoblastic leukemia. Pediatr Blood Cancer. 2011;56:1078–87.CrossRefPubMed Ek T, Josefson M, Abrahamsson J. Multivariate analysis of the relation between immune dysfunction and treatment intensity in children with acute lymphoblastic leukemia. Pediatr Blood Cancer. 2011;56:1078–87.CrossRefPubMed
26.
go back to reference Inaba H, Hartford CM, Pei D, Posner MJ, Yang J, Hayden RT, et al. Longitudinal analysis of antibody response to immunization in paediatric survivors after allogeneic haematopoietic stem cell transplantation. Br J Haematol. 2012;156:109–17.CrossRefPubMed Inaba H, Hartford CM, Pei D, Posner MJ, Yang J, Hayden RT, et al. Longitudinal analysis of antibody response to immunization in paediatric survivors after allogeneic haematopoietic stem cell transplantation. Br J Haematol. 2012;156:109–17.CrossRefPubMed
27.
go back to reference Shah GL, Shune L, Purtill D, Devlin S, Lauer E, Lubin M, et al. Robust vaccine responses in adult and pediatric cord blood transplantation recipients treated for hematologic malignancies. Biol Blood Marrow Transplant. 2015;21:2160–6.CrossRefPubMedPubMedCentral Shah GL, Shune L, Purtill D, Devlin S, Lauer E, Lubin M, et al. Robust vaccine responses in adult and pediatric cord blood transplantation recipients treated for hematologic malignancies. Biol Blood Marrow Transplant. 2015;21:2160–6.CrossRefPubMedPubMedCentral
28.
go back to reference King SM, Saunders EF, Petric M, Gold R. Response to measles, mumps and rubella vaccine in paediatric bone marrow transplant recipients. Bone Marrow Transplant. 1996;17:633–6.PubMed King SM, Saunders EF, Petric M, Gold R. Response to measles, mumps and rubella vaccine in paediatric bone marrow transplant recipients. Bone Marrow Transplant. 1996;17:633–6.PubMed
29.
go back to reference Spoulou V, Giannaki M, Vounatsou M, Bakoula C, Grafakos S. Long-term immunity to measles, mumps and rubella after mmr vaccination among children with bone marrow transplants. Bone Marrow Transplant. 2004;33:1187–90.CrossRefPubMed Spoulou V, Giannaki M, Vounatsou M, Bakoula C, Grafakos S. Long-term immunity to measles, mumps and rubella after mmr vaccination among children with bone marrow transplants. Bone Marrow Transplant. 2004;33:1187–90.CrossRefPubMed
30.
go back to reference Aytac S, Yalcin SS, Cetin M, Yetgin S, Gumruk F, Tuncer M, et al. Measles, mumps, and rubella antibody status and response to immunization in children after therapy for acute lymphoblastic leukemia. Pediatr Hematol Oncol. 2010;27:333–43.CrossRefPubMed Aytac S, Yalcin SS, Cetin M, Yetgin S, Gumruk F, Tuncer M, et al. Measles, mumps, and rubella antibody status and response to immunization in children after therapy for acute lymphoblastic leukemia. Pediatr Hematol Oncol. 2010;27:333–43.CrossRefPubMed
31.
go back to reference Shaw PJ, Bleakley M, Burgess M. Safety of early immunization against measles/mumps/rubella after bone marrow transplantation. Blood. 2002;99:3486–586.CrossRefPubMed Shaw PJ, Bleakley M, Burgess M. Safety of early immunization against measles/mumps/rubella after bone marrow transplantation. Blood. 2002;99:3486–586.CrossRefPubMed
32.
go back to reference Gouveia-Alves F, Gouveia R, Ginani VC, Seber A, Kuramoto DA, Murad GFA, et al. Adherence and immune response to revaccination following hematopoietic stem cell transplantation at a pediatric onco-hematology reference center. Transpl Infect Dis. 2018;20:e12903.CrossRefPubMed Gouveia-Alves F, Gouveia R, Ginani VC, Seber A, Kuramoto DA, Murad GFA, et al. Adherence and immune response to revaccination following hematopoietic stem cell transplantation at a pediatric onco-hematology reference center. Transpl Infect Dis. 2018;20:e12903.CrossRefPubMed
33.
go back to reference Aurpibul L, Puthanakit T, Sirisanthana T, Sirisanthana V. Persistence of measles, mumps, and rubella protective antibodies 3 years after revaccination in hiv-infected children receiving antiretroviral therapy. Clin Infect Dis. 2010;50:1415–8.CrossRefPubMed Aurpibul L, Puthanakit T, Sirisanthana T, Sirisanthana V. Persistence of measles, mumps, and rubella protective antibodies 3 years after revaccination in hiv-infected children receiving antiretroviral therapy. Clin Infect Dis. 2010;50:1415–8.CrossRefPubMed
34.
go back to reference Schenk J, Abrams S, Theeten H, Van Damme P, Beutels P, Hens N. Immunogenicity and persistence of trivalent measles, mumps, and rubella vaccines: a systematic review and meta-analysis. Lancet Infect Dis. 2021;21:286–95.CrossRefPubMed Schenk J, Abrams S, Theeten H, Van Damme P, Beutels P, Hens N. Immunogenicity and persistence of trivalent measles, mumps, and rubella vaccines: a systematic review and meta-analysis. Lancet Infect Dis. 2021;21:286–95.CrossRefPubMed
35.
go back to reference Pandit A, Leblebjian H, Hammond SP, Laubach JP, Richardson PG, Baden LR, et al. Safety of live-attenuated measles-mumps-rubella and herpes zoster vaccination in multiple myeloma patients on maintenance lenalidomide or bortezomib after autologous hematopoietic cell transplantation. Bone Marrow Transpl. 2018;53:942–5.CrossRef Pandit A, Leblebjian H, Hammond SP, Laubach JP, Richardson PG, Baden LR, et al. Safety of live-attenuated measles-mumps-rubella and herpes zoster vaccination in multiple myeloma patients on maintenance lenalidomide or bortezomib after autologous hematopoietic cell transplantation. Bone Marrow Transpl. 2018;53:942–5.CrossRef
36.
go back to reference Desjardins M, Mitre X, Sherman AC, Walsh SR, Cheng MP, Kanjilal S, et al. Safety of live-attenuated measles, mumps, and rubella vaccine administered within 2 years of hematopoietic cell transplant. Open Forum Infect Dis. 2021;8:504.CrossRef Desjardins M, Mitre X, Sherman AC, Walsh SR, Cheng MP, Kanjilal S, et al. Safety of live-attenuated measles, mumps, and rubella vaccine administered within 2 years of hematopoietic cell transplant. Open Forum Infect Dis. 2021;8:504.CrossRef
37.
go back to reference Aoki T, Kamimura T, Yoshida S, Mori Y, Kadowaki M, Kohno K, et al. Safety and seropositivity after live attenuated vaccine in adult patients receiving hematopoietic stem cell transplantation. Biol Blood Marrow Transpl. 2019;25:1576–85.CrossRef Aoki T, Kamimura T, Yoshida S, Mori Y, Kadowaki M, Kohno K, et al. Safety and seropositivity after live attenuated vaccine in adult patients receiving hematopoietic stem cell transplantation. Biol Blood Marrow Transpl. 2019;25:1576–85.CrossRef
Metadata
Title
Measles, mumps, and rubella revaccination in children after completion of chemotherapy and hematopoietic stem cell transplantation: a single-center prospective efficacy and safety analysis
Authors
Min Wang
Qing Yuan
Peng-Fei Deng
Yi Fei
Hua Zhang
Fen Zhou
Wen-Juan Chen
Qing Cao
Jing Chen
Yi-Jin Gao
Publication date
23-04-2023
Publisher
Springer Nature Singapore
Published in
World Journal of Pediatrics / Issue 11/2023
Print ISSN: 1708-8569
Electronic ISSN: 1867-0687
DOI
https://doi.org/10.1007/s12519-023-00721-x

Other articles of this Issue 11/2023

World Journal of Pediatrics 11/2023 Go to the issue