The only described exception regards eight children with malignant lymphoma, four of whom developed severe varicella after vaccination [35], [36] and [37]; however, in these cases,

the vaccine had been administered when the patients were still on maintenance therapy. Nothing is known on the immunogenicity, efficacy and safety of the use of live attenuated influenza vaccine in oncological children as no studies have yet been published. Although there are some exceptions [11], most studies have found that diphtheria and tetanus antibody titres in children receiving chemotherapy for ALL or solid tumours are higher than the limit for protection, although the intensity LEE011 of chemotherapy is critical in conditioning absolute values [6], [10], [19], [21] and [22]. Moreover, although children on maintenance chemotherapy have lower than protective pre-booster antibody titres, they develop protective titres of both after revaccination [38], Dorsomorphin clinical trial [39] and [40]. Kung et al. [38], Ridgway et al. [39], Ercan et al.

[11] and Zengin and Sarper [40] found protective titres against diphtheria and tetanus in respectively 90% and 100%, 92% and 100%, 100% and 100%, and 81% and 100% of patients who were revaccinated with diphtheria and tetanus toxoids during remission. However, the best results have been obtained when the revaccination is administered 3 months after discontinuing chemotherapy [37], [38], [39] and [40]. No differences in safety have been observed in comparison with the healthy population [6], [10], [11], [19], [21], [22], [37], [38], [39] and [40]. Pertussis

remains a common infection throughout the world because immunity after the disease or vaccination seems to last for no more than 5 years [41] and [42]. This explains why there is still no agreement as to whether adolescents need booster doses. There are few data regarding pertussis epidemiology or pertussis vaccine Etomidate administration in children with cancer, mainly because it is difficult to assess immune response to pertussis [6] and [11]. Ercan et al. found that children with ALL on maintenance therapy who were vaccinated with acellular pertussis vaccine before the onset of the disease had low pertussis antibody titres, whereas those who had discontinued chemotherapy for 3–6 months had antibody concentrations in the same range as newly diagnosed patients and healthy controls [11]. The administration of a booster dose evoked a similarly significant immune response in both groups of patients, whose antibody titres increased 2–5 times, but the response was significantly lower than that observed in healthy children [11].