Impact of Chemotherapy on Vaccine Immunogenicity and Revaccination Response of Acute Lymphoblastic Leukemia—A Systematic Review and Meta-Analysis

Background: Chemotherapy, a cornerstone treatment for Acute Lymphoblastic Leukemia (ALL), can compromise immune function, leading to impaired immune memory function and diminished responses to revaccination. This systematic review and meta-analysis sought to evaluate the impact of chemotherapy on th...

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Main Authors: Yuyuan Zeng, Chuanyu Yang, Xihan Li, Qi An, Bo Zhou, Wenquan Niu, Yu Tian, Yifei Cheng, Lin Wang
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Vaccines
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Online Access:https://www.mdpi.com/2076-393X/13/6/605
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author Yuyuan Zeng
Chuanyu Yang
Xihan Li
Qi An
Bo Zhou
Wenquan Niu
Yu Tian
Yifei Cheng
Lin Wang
author_facet Yuyuan Zeng
Chuanyu Yang
Xihan Li
Qi An
Bo Zhou
Wenquan Niu
Yu Tian
Yifei Cheng
Lin Wang
author_sort Yuyuan Zeng
collection DOAJ
description Background: Chemotherapy, a cornerstone treatment for Acute Lymphoblastic Leukemia (ALL), can compromise immune function, leading to impaired immune memory function and diminished responses to revaccination. This systematic review and meta-analysis sought to evaluate the impact of chemotherapy on the immunogenicity of prior vaccinations and subsequent revaccination responses in children with ALL. Methods: A comprehensive search was conducted through PubMed, Embase, Web of Science, and Medline. Search time was 9 January 2025. R 4.4.2 was employed for data analysis. Results: A total of 29 relevant studies were identified, with 8 undergoing meta-analysis. The pooled antibody seropositive rates (SPR) for vaccines against Hepatitis B Virus (HBV), Hepatitis A Virus (HAV), diphtheria, tetanus, pertussis, measles, mumps, rubella, varicella, and Pneumococcal Conjugate Vaccine (PCV) demonstrated a statistically significant decline after chemotherapy in ALL patients (<i>p</i> < 0.0001). Subgroup analysis further revealed marked and heterogeneous declines in SPR after chemotherapy, with the magnitude of reduction varying significantly across vaccines—tetanus, HBV, HAV, measles, mumps, and rubella (Subgroup differences, <i>p</i> = 0.0037). Conclusions: This review provides an updated assessment of this critical topic, representing the first meta-analysis specifically focused on the effects of chemotherapy on different vaccines’ immunogenicity in children with ALL.
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spelling doaj-art-aee7ee9e64824375b41f902524273f442025-08-20T03:32:28ZengMDPI AGVaccines2076-393X2025-06-0113660510.3390/vaccines13060605Impact of Chemotherapy on Vaccine Immunogenicity and Revaccination Response of Acute Lymphoblastic Leukemia—A Systematic Review and Meta-AnalysisYuyuan Zeng0Chuanyu Yang1Xihan Li2Qi An3Bo Zhou4Wenquan Niu5Yu Tian6Yifei Cheng7Lin Wang8Capital Institute of Pediatrics, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100020, ChinaCapital Institute of Pediatrics, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100020, ChinaSchool of Public Health, Capital Medical University, Beijing 100069, ChinaDepartment of Child Health Care, Capital Center for Children’s Health, Capital Medical University, Beijing 100020, ChinaDepartment of Child Health Care, Capital Center for Children’s Health, Capital Medical University, Beijing 100020, ChinaCenter for Evidence-Based Medicine, Capital Center for Children’s Health, Capital Medical University, Beijing 100020, ChinaDepartment of Child Health Care, Capital Center for Children’s Health, Capital Medical University, Beijing 100020, ChinaPeking University Institute of Hematology, Peking University People’s Hospital, Peking University, Beijing 100044, ChinaDepartment of Child Health Care, Capital Center for Children’s Health, Capital Medical University, Beijing 100020, ChinaBackground: Chemotherapy, a cornerstone treatment for Acute Lymphoblastic Leukemia (ALL), can compromise immune function, leading to impaired immune memory function and diminished responses to revaccination. This systematic review and meta-analysis sought to evaluate the impact of chemotherapy on the immunogenicity of prior vaccinations and subsequent revaccination responses in children with ALL. Methods: A comprehensive search was conducted through PubMed, Embase, Web of Science, and Medline. Search time was 9 January 2025. R 4.4.2 was employed for data analysis. Results: A total of 29 relevant studies were identified, with 8 undergoing meta-analysis. The pooled antibody seropositive rates (SPR) for vaccines against Hepatitis B Virus (HBV), Hepatitis A Virus (HAV), diphtheria, tetanus, pertussis, measles, mumps, rubella, varicella, and Pneumococcal Conjugate Vaccine (PCV) demonstrated a statistically significant decline after chemotherapy in ALL patients (<i>p</i> < 0.0001). Subgroup analysis further revealed marked and heterogeneous declines in SPR after chemotherapy, with the magnitude of reduction varying significantly across vaccines—tetanus, HBV, HAV, measles, mumps, and rubella (Subgroup differences, <i>p</i> = 0.0037). Conclusions: This review provides an updated assessment of this critical topic, representing the first meta-analysis specifically focused on the effects of chemotherapy on different vaccines’ immunogenicity in children with ALL.https://www.mdpi.com/2076-393X/13/6/605chemotherapyvaccineantibodyimmunogenicityrevaccination responseacute lymphoblastic leukemia
spellingShingle Yuyuan Zeng
Chuanyu Yang
Xihan Li
Qi An
Bo Zhou
Wenquan Niu
Yu Tian
Yifei Cheng
Lin Wang
Impact of Chemotherapy on Vaccine Immunogenicity and Revaccination Response of Acute Lymphoblastic Leukemia—A Systematic Review and Meta-Analysis
Vaccines
chemotherapy
vaccine
antibody
immunogenicity
revaccination response
acute lymphoblastic leukemia
title Impact of Chemotherapy on Vaccine Immunogenicity and Revaccination Response of Acute Lymphoblastic Leukemia—A Systematic Review and Meta-Analysis
title_full Impact of Chemotherapy on Vaccine Immunogenicity and Revaccination Response of Acute Lymphoblastic Leukemia—A Systematic Review and Meta-Analysis
title_fullStr Impact of Chemotherapy on Vaccine Immunogenicity and Revaccination Response of Acute Lymphoblastic Leukemia—A Systematic Review and Meta-Analysis
title_full_unstemmed Impact of Chemotherapy on Vaccine Immunogenicity and Revaccination Response of Acute Lymphoblastic Leukemia—A Systematic Review and Meta-Analysis
title_short Impact of Chemotherapy on Vaccine Immunogenicity and Revaccination Response of Acute Lymphoblastic Leukemia—A Systematic Review and Meta-Analysis
title_sort impact of chemotherapy on vaccine immunogenicity and revaccination response of acute lymphoblastic leukemia a systematic review and meta analysis
topic chemotherapy
vaccine
antibody
immunogenicity
revaccination response
acute lymphoblastic leukemia
url https://www.mdpi.com/2076-393X/13/6/605
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