Kinder- und Jugendmedizin 2014; 14(01): 35-37
DOI: 10.1055/s-0038-1629370
Impfen
Schattauer GmbH

Impfungen bei Kindern und Jugendlichen mit Krebserkrankungen

Vaccinations in children and adolescents undergoing therapy for cancer
T. Lehrnbecher
1   Pädiatrische Hämatologie und Onkologie, Klinik für Kinder- und Jugendmedizin, Universität Frankfurt/Main
› Author Affiliations
Further Information

Publication History

Eingereicht am:26 June 2013

angenommen am:05 July 2013

Publication Date:
31 January 2018 (online)

Zusammenfassung

Kinder und Jugendliche mit Krebserkrankungen verlieren durch die Chemotherapie oft den vorhandenen Impfschutz. Basierend auf Daten zur Immunrekonstitution nach Chemotherapie und kleineren klinischen Studien wird im Allgemeinen eine Revakzinierung mit Totimpfstoffen ab drei Monaten und eine Revakzinierung mit Lebendimpfstoffen ab sechs Monaten nach Beendigung der konventionellen Chemotherapie empfohlen. Zusätzlich sollten die immunsupprimierten Patienten durch Umgebungsimpfungen geschützt werden, was unter anderem für Varizellen und Influenza gilt.

Summary

Children and adolescents undergoing therapy for cancer often loose their protective immunity to vaccine-preventable diseases. Most experts agree that revaccination for inactivated (dead) vaccines should be performed at three months and for life-attenuated vaccines at six months after the end of conventional chemotherapy, respectively. In addition, immunocompromised patients should be protected by vaccination of the family and close friends, which is important for diseases such as influenza and measles.

 
  • Literatur

  • 1 Bate J, Chisholm J, Heath PT. et al. PEPtalk: postexposure prophylaxis against varicella in children with cancer. Arch Dis Child 2011; 96: 841-845.
  • 2 Calaminus G, Hense B, Laws HJ. et al. Diphtheria (D) and tetanus (T) antibody values in children with acute lymphoblastic leukaemia (ALL) after treatment according to Co-ALL 05/92. Klin Padiatr 2007; 219: 355-360.
  • 3 Caniza MA, Hunger SP, Schrauder A. et al. The controversy of varicella vaccination in children with acute lymphoblastic leukemia. Pediatr Blood Cancer 2012; 58: 12-16.
  • 4 Demicheli V, Rivetti A, Debalini MG, Di Pietrantonj C. Vaccines for measles, mumps and rubella in children. Cochrane Database Syst Rev 2012; 2: CD004407
  • 5 Ek T, Mellander L, Andersson B, Abrahamsson J. Immune reconstitution after childhood acute lymphoblastic leukemia is most severely affected in the high risk group. Pediatr Blood Cancer 2005; 44: 461-468.
  • 6 Esposito S, Cecinati V, Brescia L, Principi N. Vaccinations in children with cancer. Vaccine 2010; 28: 3278-3284.
  • 7 Fioredda F, Cavillo M, Banov L. et al. Immunization after the elective end of antineoplastic chemotherapy in children. Pediatr Blood Cancer 2009; 52: 165-168.
  • 8 Lehrnbecher T, Foster C, Vazquez N. et al. Therapy-induced alterations in host defense in children receiving chemotherapy. J Ped Hematol Oncol 1997; 19: 399-417.
  • 9 Lehrnbecher T, Koehl U, Wittekindt B. et al. Changes in host defence induced by malignancies and antineoplastic treatment: implication for immunotherapeutic strategies. Lancet Oncol 2008; 9: 269-278.
  • 10 Lehrnbecher T, Schubert R, Behl M. et al. Impaired pneumococcal immunity in children after treatment for acute lymphoblastic leukaemia. Br J Haematol 2009; 147: 700-705.
  • 11 Lehrnbecher T, Schubert R, Allwinn R. et al. Revaccination of children after completion of standard chemotherapy for acute lymphoblastic leukaemia: a pilot study comparing different schedules. Br J Haematol 2011; 152: 754-757.
  • 12 Lehrnbecher T, Langer R, Allwin R. et al. Impact of conventional chemotherapy on humoral immunity against measles, mumps, rubella Varicella-Zoster-virus in children treated for cancer (abstract). Pediatr Blood Cancer 2013; 60P-0488.
  • 13 Lehrnbecher T, Berger C, Beutel K. et al. Infektionen bei pädiatrisch-onkologischen Patienten. In: DGPI Handbuch, Deutsche Gesellschaft für Pädiatrische Infektiologie (Hrsg), 6. Aufl. Stuttgart: Georg Thieme Verlag; 2013: 705-716.
  • 14 Mahajan A, English MW, Jenney ME, Foot A. Survey of immunisation practices in the United Kingdom during and following completion of anti-cancer chemotherapy in children. Med Pediatr Oncol 2003; 40: 270-271.
  • 15 Meisel R, Toschke AM, Heiligensetzer C. et al. Increased risk for invasive pneumococcal diseases in children with acute lymphoblastic leukaemia. Br J Haematol 2007; 137: 457-460.
  • 16 Patel SR, Ortin M, Cohen BJ. et al. Revaccination of children after completion of standard chemotherapy for acute leukemia. Clin Infect Dis 2007; 44: 635-642.
  • 17 Ruggiero A, Battista A, Coccia P. et al. How to manage vaccinations in children with cancer. Pediatr Blood Cancer 2011; 57: 1104-1108.
  • 18 Ständige Impfkommission (STIKO) am Robert Koch-Institut. Hinweise zu Impfungen für Patienten mit Immundefizienz. Epid Bull Sonderdruck 10. November 2005: 1-12.
  • 19 van Tilburg CM, Sanders EA, Rovers MM. et al. Loss of antibodies and response to (re-)vaccination in children after treatment for acute lymphocytic leukemia: a systematic review. Leukemia 2006; 20: 1717-1722.
  • 20 van Tilburg CM, Sanders EA, Nibbelke EE. et al. Impact of reduced chemotherapy treatment for good risk childhood acute lymphoblastic leukaemia on infectious morbidity. Br J Haematol 2011; 152: 433-440.