Application of a Live Varicella Vaccine in Children With Acute Leukemia or Other Malignant Diseases

Abstract

A live varicella vaccine was used in 11 susceptible children in remission from acute leukemia, 10 of whom were in remission for 6 mo. or less, and in 6 children with neuroblastoma and retinoblastoma. In the immunological checkup before vaccination, most of them showed a positive reaction in the skin tests with dinitrochlorobenzene, phytohemagglutinin, purified protein derivative and viral antigens. Leukopenia (3 cases, less than 3000/ mm3) and decreased Ig[immunoglobulin]G level (2 cases, 380 mg/dl and 445 mg/dl) were observed in the children with leukemia. Anticancer medication was suspended from 1 wk before vaccination to 1 wk after vaccination. The only clinical reaction was a minute rash that appeared 3 wk after vaccination in 2 children with leukemia and that disappeared within 3 days. Serological responses by complement fixing and neutralizing (NT) tests were detected in all the vaccinated children 4 wk after vaccination, and NT antibody was still detected 28 mo. after vaccination in the 2 patients tested. Of the vaccinees, 3 were exposed to natural varicella at home and in the classroom 2-18 mo. after vaccination, but they were free from any varicella symptoms.