Humoral response to hemagglutinin components of influenza vaccine in patients with non-Hodgkin malignant lymphoma
Humoral response to hemagglutinin components of influenza vaccine in patients with non-Hodgkin malignant lymphoma
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DOI：
10.1016/j.vaccine.2006.05.100
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发表时间：
2006-11-10
期刊：
影响因子：
5.5
通讯作者：
Bilinski, Przemyslaw
中科院分区：
文献类型：
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作者：
Brydak, Lidia B.;Machala, Magdalena;Bilinski, Przemyslaw
淋巴瘤疾病和在这种情况下使用的免疫抑制药物引起免疫紊乱，增加了包括流感在内的严重感染的风险。有观点认为高危人群对疫苗接种反应不明显，疫苗接种可能导致慢性疾病加重。目的是评估32名非霍奇金恶性淋巴瘤患者（平均年龄57.2岁）和32名健康受试者（平均年龄44.3岁）对流感疫苗的体液反应。16例患者接受免疫抑制药物治疗（A组），11例患者未接受免疫抑制药物治疗（B组）。用血凝抑制试验测定接种前和接种1个月后血清中抗血凝素（抗ha）抗体水平。在研究期间，从有流感症状的人身上收集鼻咽拭子，以检测感染的病原。接种疫苗后的抗ha抗体水平显著高于接种前的水平，患者的平均倍数增加（MFI）范围为9.3至12.2，健康受试者的平均倍数增加范围为27.6至44.3。接种后抗ha抗体滴度> 1:40（保护率）的患者比例为59.4% ~ 68.8%。接种疫苗后抗ha抗体滴度（应答率）至少增加4倍的患者百分比从46.9%到68.8%不等。在接受免疫抑制药物治疗的患者和未接受免疫抑制药物治疗的患者之间，抗体水平无显著差异。实验室未确诊呼吸道感染。这项研究表明，流感疫苗在非霍奇金恶性淋巴瘤患者中的免疫原性较低，因为与健康人相比，流感疫苗诱导的抗体产生滴度较低。尽管如此，考虑到高MFI值和应答率以及对个别患者的保护作用，应向这一群体提供流感疫苗。(c) 2006 Elsevier Ltd.版权所有。
Lymphoma disease and immunosuppressive drugs used in this case cause immunity disorders increasing the risk of severe infections, including influenza. There are opinions that patients from high-risk group are not able to respond to vaccination effectively and vaccination may contribute to exacerbation of the chronic disease. The aim was to assess humoral response to influenza vaccine in 32 patients with non-Hodgkin malignant lymphoma (mean age 57.2) and 32 healthy subjects (mean age 44.3). Sixteen patients were treated with immunosupressive drugs (group A) and 11 were not subjected to this therapy (group B). Levels of antihemagglutinin (anti-HA) antibodies were assessed in sera before vaccination and after I month by hemagglutination inhibition test. Nasal and throat swabs were collected from persons with influenza symptoms during the study to detect the etiological agent of the infection. Post-vaccination anti-HA antibody levels were significantly higher than pre-vaccination values and mean fold increases (MFI) ranged from 9.3 to 12.2 in patients and from 27.6 to 44.3 in healthy subjects. The percentage of patients with the protective anti-HA antibody titers > 1:40 (protection rate) ranged after vaccination from 59.4% to 68.8%. The percentage of patients with at least a four-fold increase of anti-HA antibody titers (response rate) after vaccination ranged from 46.9% to 68.8%. There were no significant differences in antibody levels between patients treated with immunosuppressive drugs and those not treated. No respiratory infections were laboratory confirmed. This study showed that influenza vaccine is less immunogenic in patients with non-Hodgkin malignant lymphoma, because it induces antibody production in lower titers in comparison to the production in healthy people. Despite this, influenza vaccine should be offered to this group, considering high MFI values and response rates as well as the protective effect for individual patients. (c) 2006 Elsevier Ltd. All rights reserved.