Which immunization for children treated for solid tumors?

There is no agreement on immunization of children treated with chemotherapy (CT) for solid tumors. Based on a review of the literature, we have attemp ted to establish guidelines on this subject. Except for hepatitis B vaccine , there is no argument to support the use of vaccine during CT After a stan dard CT, a 3-month washout period appears to be necessary before starting a n immunization program for a child not previously vaccinated, or to proceed with the recommended booster injections for diphteria anatoxin, tetanus va ccine, poliomyelitis inactivated vaccine, pertussis vaccine, and haemophilu s Influenza type b vaccine if the child is less than 5 years old. For mumps , measles, and rubella live vaccines, a longer post-CT washout of 6 months is suggested for the initial immunization, or for a revaccination of a chil d proved to be negative for all three serologies. Following high-dose CT a minimal 12-months term and a normalization of the blood lymphocytes count i s necessary before planning booster injections once having checked for anti diphteria, tetanic, polio, measles, mumps, rubella and +/- haemophilus anti body titles. We don't find any reason to recommend a systematic varicella i mmunization in pediatric oncology. Pneumococcal vaccine is recommended in c ase of asplenia. Any other vaccination (BCG, influenza, yellow fever) must be evaluated individually. (C) 2001 Editions scientifiques et medicales Els evier SAS.