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Bu çalışmada çocuk onkoloji servisinde solid organ malignitesi tanısı ile takip edilmiş olan hastaların kemoterapi öncesi ve sonrası hepatit b virusu (HBV) ve varisella zoster virusu (VZV) serolojilerinin değerlendirilme oranları, antikor yanıtlarının tedavi sonrası değişip değişmediğinin saptanması ve buna neden olabilecek faktörlerin araştırılması amaçlanmıştır. Çalışmamızda Mart 2016-Nisan 2019 tarihleri arasında çocuk onkoloji servisinde solid organ malignitesi tanısı ile takip edilen ve kemoterapi almış olan hastaların dosyaları geriye dönük olarak değerlendirilmiştir. Çocukluk çağı kanseri (lösemi dışı) nedeni ile takip edilmiş olan 75 hastanın 24’ü (%32) kız idi. Anti Hbs antikoru bakılan 70 hastanın 44’ünde (%58.6) anti Hbs pozitif, anti VZV antikoru bakılan 62 hastadan, 48’inde (%64) anti VZV pozitif idi. Kemoterapi öncesi anti Hbs pozitif olan 44 hastanın 8’inde (%18.1) kemoterapi sonrası anti Hbs negatifleşmiştir. Kemoterapi öncesi anti VZV pozitif saptanan 48 hastanın 4’ünde (%8.3) kemoterapi sonrası anti VZV negatifleşmiştir. Tek doz suçiçeği aşı yanıtının kemoterapi sonrası kaybolma oranı, doğal yol ile gelişmiş antikor yanıtının negatifleşme oranından daha yüksek saptanmıştır. Daha önce bu iki durumu karşılaştıran çalışma olmadığı için verilerimiz yol gösterici olabilir. Pürin analoğu, siklofosfamid, steroid kullanımı ve hastalık evresi ile anti HBs ve anti VZV serolojilerinin negatifleşmesi arasında ilişki saptanmamıştır. Onkoloji hastalarının tedavi öncesi ve sonrası bağışıklık durumlarının değerlendirilmesi konusunda daha geniş çaplı çalışmalara ihtiyaç vardır ve bu hastalar için rehberler oluşturulması uygun olacaktır.
This study aims to determine the ratio of assessment of the serologies of patients with solid organ malignity diagnosis in the child oncology service, pre- and post-chemotherapy hepatitis B virus (HBV) and varisella zoster virus (VZV) serologies, whether the antibodies are altered after treatment, and to investigate the factors that may cause it. In our study, from March to April 2019, the files of patients who were traced with solid organ malignity diagnosis in the child oncology service and received chemotherapy were recurrently evaluated. 24 (32%) of the 75 patients who were followed by the cause of childhood cancer (non-lasemia) were girls. Anti-Hbs antibodies were treated in 44 of 70 patients (58 percent). 6) anti-Hbs positive, anti-VZV antibodies treated in 62 patients, 48 (64) were anti-VZV positive. In 8 of 44 patients with pre-chemotherapy anti-Hbs positive (18.1%), anti-Hbs post-chemotherapy was negative. In 4 of the 48 patients diagnosed anti-VZV positive before chemotherapy (8.3%), anti-VZV after chemotherapy was negative. The rate of disappearance after chemotherapy of the single-dose vaccine response has been found higher than the rate of negativization of the advanced antibodies response by natural means. Since there has been no previous study to compare these two situations, our data may be guiding. There is no connection between purine analogue, cyclophosphamide, steroid use and the stage of the disease and the negativization of anti-HBs and anti-VZV serologies. More extensive studies on the assessment of immunity conditions of oncological patients before and after treatment are needed and it will be appropriate to create guidelines for these patients.
The aim of this study was to determine the rates of hepatitis b virus (HBV) and varicella zooster virus (VZV) serology assesment before and after chemotherapy, antibody response changes after therapy, and factors affecting this situation. In our study we evaluated the files of patients who were followed up with malignancy in the pediatric oncology department between March 2016 and April 2019 retrospectively. Twenty four (32%) of the 75 patients followed for childhood cancer other than leukemia were girls. Anti Hbs antibody was evaluated in 70 patients and 44 (58.6%) were positive, anti VZV antibody was evaluted in 62 patients and 48 (64%) was positive. Of the 44 patients who had anti Hbs seropositivity before chemotherapy, 8 (18.1%) were seronegative after therapy. Anti VZV was negative after therapy in 4 (8.3%) of 48 patients who had anti VZV seropositivity before chemotherapy. The rate of disappearance of vaccine response after a single dose varicella vaccine was found to be higher than the rate of negative response of naturally developed varicella antibody response. Since there were no studies comparing these two situations before, this data may be a guide. There was no correlation between purine analogue, cyclophosphamide, steroid use, disease stage and disappearance of anti Hbs and VZV antibodies. Further studies are needed to evaluate the pre-and post-treatment immune status of oncology patients, and guidelines should be developed for these patients.
Field : Sağlık Bilimleri
Journal Type : Uluslararası
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