A scoring system for the effectiveness of hepatitis-B vaccination in children receiving treatment for cancer

The purpose of this study was to determine the variables that may influence the outcome of a Hepatitis-B (HBV) vaccination program in children who were receiving treatment for cancer. This study was performed retrospectively using hospital records belonging to the children with cancer who received HBV vaccine in our center between January 1993 and June 1998. Only patients who received three doses of HBV vaccine for three consecutive months and whose antibody titers were determined at least once within the first six months after the last dose of vaccination were included in this study. The effect of patients' age, sex, tumor type and vaccine type on the outcome of vaccine response were evaluated. To assess the effect of combined modality treatment on the vaccine response, a risk factor scoring was calculated for each patient. In addition, possible relationship between the vaccination response and the lowest blood lymphocyte concentration during the vaccination period was also evaluated. A total of 52 patients were studied. The rate of seroconversion was 65% in the overall group. No significant effects of patients' age, sex, tumor type and vaccine type on the vaccine response were seen. When surgery, radiotherapy, chemotherapy and infectious complications are accepted as risk factors, the total risk factor score showed significant difference among the groups according to anti-HBs titers. The anti-HBs titers showed a significant correlation with the lowest concentration of blood lymphocytes during the vaccination period. The total risk factor scoring and blood lymphocyte concentration helped to predict the response to immunization in children with cancer

Catheter-associated recurrent intracardiac thrombosis and facotr V Leiden mutation in a child with non-Hodgkin's lymphoma

Patients with cancer have an increased risk for thromboembolism, which might be related to several factors including central venous catheters and chemotherapeutics. Congenital prothrombotic risk factors might also contribute to thrombotic events. In this report, we present a catheter-related recurrent intracardiac thrombosis in a boy with non-Hodgkin's lymphoma and factor V Leiden mutation. Screening for factor V Leiden mutation in children with cancer and recurrent thrombotic events is recommended. Periodic echocardiography may be considered for a group of patients if the catheter tip is in the right atrium and therapy includes L-asparaginase and corticosteroids