Humoral immunity state in survivors of pediatric acute lympho-blastic leukemia

Background and Objective: Since there are very few studies on the immunodeficiency state of the Iranian survivors of pediatric acute lymphoblastic leukemia (ALL), we conducted this study to determine the prevalence of humoral defects in children with ALL at least one year after completion of chemotherapy. Methods: In this study, antibody titers for mumps, rubeola, rubella, tetanus and diphtheria toxoids, pertussis and poliovirus were measured in 28 survivor of childhood ALL and 29 normal children. Also, immunoglobulins titers for all participants were evaluated. Results: In spite of normal serum immunoglobulin levels in all participants, the percentage of children with ALL who had protective titers was markedly lower than that anticipated for immunized controls (p<0.001). The rate of protective titers for mumps, rubeola, rubella, tetanus and diphtheria toxoids, pertussis and poliovirus were 7.1, 50, 25, 35.7, 10.7, 21.4, and 10.7 percent in patients and 93.1, 93.1, 100, 96.6, 86.2, 82.8, and 100 percent in controls, respectively. Conclusion: The prevalence of humoral immune defects was high among the survivors of pediatric ALL. It appears that these survivors are at risk of developing these bacterial and viral infections and therefore have to be re-vaccinated as required.