A Study of Immunogenicity of Intensified Hepatitis B Vaccination in Children Being Treated for Acute Lymphoblastic Leukemia.

Children with acute lymphocytic leukemia (ALL) are at an increased risk of acquiring hepatitis B infection due to repeated exposure to blood products. They have poor response to vaccination due to immunosuppressive effects of malignant disease and chemotherapy; hence necessitating vaccination with increased doses or increased amount of vaccine or both. The authors studied 44 patients (32 boys and 12 girls) given double dose hepatitis B vaccination at 0, 1 and 2 mo during induction and consolidation phase of therapy. Of the thirty patients who completed the study, only 13 (43.34%) developed protective antibody levels (titres >10 mIU/ml) measured 4 wk after the third dose. The authors conclude that with three double dose schedule of Hepatitis B vaccination, response rate is poor. Therefore, for protection from Hepatitis B infection during initial phase of therapy, there is a need to provide passive immunization.