Chemotherapy-Induced Serological Impact in Hepatitis B Surface Antibody Titers in Children with Acute Lymphoblastic Leukemia

Abstract

Abstract Objective In our study, we aimed to assess the differences in antibody titers against hepatitis B virus (HBV) prior and post leukemia therapy in children with acute lymphoblastic leukemia (ALL). Methods Serum hepatitis B surface antibody (anti-HBs) levels of 96 ALL patients were compared before and postcessation of leukemia therapy from patients' medical records. Results Fifty-five patients were male (57.2%) and 41 patients were female (42.7%), and the mean age was 6.1 years (range, 1 ± 15 years) at the time of diagnosis. Thirty (32.3%) patients were anti-HBs negative, and 66 (68.7%) patients were anti-HBs positive at initial diagnosis. Anti-HBs–positive 66 patients were categorized into two groups, the first group consisted of 28 (42.4%) anti-HBs–negative patients, and the second group consisted of 38 (57.6%) anti-HBs–positive patients after leukemia therapy. On binary logistic regression analysis, lower initial anti-HBs titers were found to be related to anti-HBs negative results post leukemia therapy (relative risk = 3.696, 95% confidence interval: 2.046–6.678; p = 0.001). The area under the curve was 0.849 with 76.1% sensitivity (95% confidence interval: 0.60–0.87; p = 0.001) and 82.6% specificity (95% confidence interval: 0.69–0.91; p = 0.001); the initial anti-HBs titer cut-off value was found 42.9 IU/L. Conclusion Patients with low-serum anti-HBs titers before leukemia therapy were likely to become anti-HBs negative post leukemia therapy. Therefore, it is necessary to evaluate anti-HBs titers after completing immunosuppressive therapy in patients with ALL.