Page 29 - JCTR-10-5

Journal of Clinical and Translational Research 2024; 10(5): 291-295

Journal of Clinical and Translational Research

Journal homepage: http://www.jctres.com/en/home

ORIGINAL ARTICLE

Assessment of the humoral immunity against diphtheria, tetanus, and
hepatitis B among children with acute lymphocytic leukemia

Sima Omrani 1 , Fatemeh Malek * , Shiva Nazari * , Mojhgan Hashemieh 3 , Hasan Abolghasemi 2 ,
2
2
Mehrnaz Mesdaghi 4 , Zahra Khafafpour 2
1 Department of Pediatric Medicine, School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran, Pediatric Congenital
2
Hematologic Disorders Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
4
3 Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Pediatrics and Child Health, Department of
Allergy and Clinical Immunology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
ARTICLE INFO ABSTRACT

Article history: Background: Approximately all systemic therapies for childhood affect the immune system. The
Received: August 8, 2024 behavior of the immune system in leukemia patients following chemotherapy is not yet clearly
Accepted: October 15, 2024 defined. The probability of vaccination failure and the need for revaccination remain challenging
Published Online: October 29, 2024 for these patients.
Aim: To evaluate the humoral immunity against diphtheria, tetanus, and hepatitis B in children
Keywords: with acute lymphocytic leukemia (ALL) immediately and 6 months after chemotherapy.
Leukemia Materials and Methods: In the present prospective cohort study, 21 patients with ALL referred
Pediatrics to Mofid Children’s Hospital were studied immediately and 6 months after chemotherapy. Serum
Immune system samples were collected from patients, and the levels of immunoglobulins (IgG, IgM, IgE, and IgA)
Immunoglobulins antibodies against diphtheria, tetanus, and hepatitis B were determined using specific enzyme-
Humoral immune system linked immunosorbent assay kits. The obtained data were analyzed using Statistical Package for
Social Sciences 21 software.
*Corresponding author: Results: A total of 13 males and 8 females with an average age of 8.6 ± 2.5 years were included
Dr. Shiva Nazari in the present study. Six months after chemotherapy, the mean level of IgG, IgM, IgE, and IgA
Pediatric Congenital Hematologic Disorders displayed an increase of 563.1 units in IgG, 11 units in IgM, 11.3 units in IgE, and 5 units in IgA
Research Center, Research Institute levels. Moreover, data revealed that 6 months after chemotherapy, the mean level of IgG antibodies
for Children’s Health, Shahid Beheshti displayed an increase of 7.09, 3.43, and 1.03 units against hepatitis B, diphtheria, and tetanus,
University of Medical Sciences, Tehran, Iran. respectively. A significant relationship was found between the antibody level against diphtheria and
Email: shnazari2000@gmail.com the age group of the patients (p = 0.003).
Conclusion: Humoral immune status was boosted after 6 months of chemotherapy, though all
Dr. Fatemeh Malek patients had some extent of lasting immune dysfunction. We indicate that survivors of childhood
Pediatric Congenital Hematologic Disorders
Research Center, Research Institute cancer have ongoing humoral immunological defects and may remain at risk for infectious
for Children’s Health, Shahid Beheshti complications after completion of therapy.
University of Medical Sciences, Tehran, Iran. Relevance for Patients: The present study indicated that systemic therapies for pediatrics with
Email: Fmalek7721@gmail.com leukemia affect the immune system. Pediatrics with leukemia may remain at risk for infectious
complications after completion of therapy.
© 2024 Author(s). This is an Open-Access
article distributed under the terms of the
Creative Commons Attribution-Noncommercial
License, permitting all non-commercial use, 1. Introduction
distribution, and reproduction in any medium,
provided the original work is properly cited. Cancer is the second leading cause of death in children under 15, and leukemia is the
most common type of cancer in this age group [1,2]. In leukemia patients, the humoral and
cellular immune systems are impaired, and the patients are immunocompromised [3,4].
Various types of leukemia affect bone marrow (BM) cells and the immune system.
For example, in chronic lymphocytic leukemia, mature B lymphocytes accumulate in

DOI: http://doi.org/10.36922/jctr.24.00050