Immunogenicity of influenza vaccination in patients with non-Hodgkin lymphoma.
ABSTRACT The purpose of this study was to assess humoral response to influenza vaccine in patients (pts) with non-Hodgkin lymphoma (NHL) as compared to healthy subjects (ctrl).
In two epidemic seasons, 2003/2004 and 2004/2005, 163 pts and 92 ctrl were vaccinated. Antibody titers to hemagglutinin (HA) and neuraminidase (NA) were measured in serum samples collected before vaccination, and 1 and 6 months apart. Changes in antibody titers were assessed by comparing geometric mean titers (GMT), mean fold increases (MFI), and seroprotection and seroresponse rates to baseline values.
Pts vaccinated in 2003/2004 had, after 1 month, increase in GMT by a factor of 8.64-26.60 for antihemagglutinin antibodies (HI) and 6.93-12.66 for antineuraminidase antibodies (NI), as compared to factor of 9.12-24.41 for HI and 4.83-10.31 for NI in ctrl. At 1 month after vaccination, seroprotection and seroresponse rates were similar in both groups, ranging from 68.42 to 84.21% and 71.93 to 94.74% in NHL, and 66.67-82.22% and 62.22-86.67% in ctrl, respectively. Pts vaccinated in 2004/2005 had increase in the GMT by a factor of 38.76-41.49 for HI and 26.59-30.31 for NI, as compared to factor of 81.19-104.32 for HI and 52.16-54.52 for NI in ctrl. Seroprotection and seroresponse rates were lower in the former group, ranging from 62.11 to 65.26% and 74.47 to 77.66%, respectively. In both seasons, pts achieved titres of antibodies greater than the protective threshold, irrespective of the previous chemotherapy administration.
The results indicate that influenza vaccination induces sufficient immune response in pts with NHL, irrespective of previous chemotherapy.
Conference Paper: JIT, truck docks, and simulationSimulation Conference Proceedings, 1988 Winter; 01/1989
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ABSTRACT: The new swine-origin influenza A (H1N1) strain (S-OIV) pandemia may expose immunodepressed cancer patients under chemotherapy to an increased risk of mortality. Here, we put into perspective available antiviral treatments and influenza vaccination efficacy in cancer patients and consider that recommendations for seasonal influenza vaccination for these patients are applicable for the upcoming S-OIV vaccines. We recommend a triple vaccination in cancer patients (seasonal influenza, S-OIV, streptococus pneumoniae), if possible at least two weeks before beginning chemotherapy. In case of an influenza-like illness under chemotherapy, the care will depend on the neutrophilic level. If neutrophil count is under 500 units/mm3, hospital admission is recommended with adapted isolation measures and the prescription of an antiviral treatment with oseltamivir 75 mg twice a day for 5 days, if the onset of symptoms occurred within 48 hours. In case of a sign of severity, antiviral treatment should be started regardless of time of the onset of symptoms. Probabilistic antibiotics should also be introduced. In the absence of neutropenia, home care should be favored, by explaining recommended hygienic measures and by starting an antiviral treatment with the same modalities as described previously. Hospital admission is indicated if a sign of severity is present. Patients under chemotherapy, if not vaccinated, who have had a contact with an infected person should receive a prophylactic antiviral treatment with oseltamivir 75 mg once a day for 10 days.Bulletin du cancer 10/2009; 96(11):1045-52. DOI:10.1684/bdc.2009.0962 · 0.64 Impact Factor
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ABSTRACT: The immune responses to influenza vaccination in patients with colorectal cancer on surveillance or active chemotherapy have not been previously reported. We conducted a prospective influenza vaccination study to determine the serological immune response rate in patients with colorectal cancer. During the 2006-2007 influenza season, patients with colorectal cancer treated at Roswell Park Cancer Institute were offered vaccination with the trivalent influenza vaccine (Fluzone, 2006-2007). Blood samples for hemagglutination inhibition (HI) assay titers were collected before and 3 months after vaccination. Response to vaccination was determined using an endpoint of ≥ 1:40 HI titer ratio or a fourfold HI increase at 3 months from vaccination. A response in HI to at least one of the 3 strains was considered an immune response. Eighty-five patients with colorectal cancer participated in the study. The immune response in the overall population was 70.6%. No differences in response were noted between the 58 patients on active chemotherapy and the 27 patients on surveillance [Odds Ratio (OR) = 0.78; P = 0.8]. The odds of response did not vary by chemotherapy regimen or by chemotherapy-vaccination timing. HI response in all 3 titers concurrently were low in both the chemotherapy (12.1%) and surveillance groups (11.1%) (OR = 1.10; P = 1). Patients with colorectal cancer mount an immune response to influenza vaccination irrespective of their chemotherapy regimen or timing. However, concurrent responses to all three strains in the individual patient with colorectal cancer are uncommon. The investigation of a booster vaccine in this population is warranted.Cancer Chemotherapy and Pharmacology 03/2010; 67(1):111-5. DOI:10.1007/s00280-010-1292-2 · 2.57 Impact Factor