Immune response after influenza vaccination in children with cancer
Immune response after influenza vaccination in children with cancer
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DOI：
10.1002/pbc.20470
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发表时间：
2005-11-01
影响因子：
3.2
通讯作者：
Hara, T
中科院分区：
文献类型：
--
作者：
Matsuzaki, A;Suminoe, A;Hara, T
目的。目的：评估三价裂解流感灭活疫苗对癌症儿童的免疫应答。程序。44名患有各种恶性肿瘤的儿童相隔24周接种了两剂流感疫苗。在第一次免疫前和第二次免疫后4周分别检测血凝素抑制(HI)抗体效价。结果。所有儿童都接种了流感疫苗，没有任何严重的不良反应。保护性滴度(在接种前滴度为40的患者中达到抗体滴度的比例)和应答率(抗体上升四倍或以上的患者的比例)分别为H1N1的72%和65%，H3N1的60%和40%，B型流感的38%和46%。然而，接受化疗的患者对甲型流感的免疫应答明显低于接受化疗的患者；甲型H1N1病毒的保护率为42%，甲型H1N1病毒的保护率为90%(P=0.006)，甲型H3N1病毒的保护率为25%，甲型H3N1病毒的保护率为83%(P=0.019)。对于乙型流感，低免疫球蛋白的有效率为29%，高于高免疫球蛋白的有效率(61%，P=0.040)。多因素分析显示，H1N1低免疫球蛋白(P<；0.001)和化疗(P=0.003)、H3N2低免疫球蛋白(P=0.008)和乙型流感低免疫球蛋白(P=0.030)和低免疫球蛋白(P=0.030)与免疫低下有关。给癌症儿童接种流感疫苗是安全的，引发的免疫反应与健康儿童相当，尽管接受化疗和/或患有化疗相关疾病的患者产生足够免疫反应的能力有限。
Purpose. To assess the immune response to inactivated trivalent split influenza vaccine in children with cancer. Procedures. Forty-four children with various types of malignancies received two doses of influenza vaccine 24 weeks apart. Hemagglutinin-inhibition (HI) antibody titers were determined in paired sera obtained just before the first vaccination and 4 weeks after the second vaccination. Results. Influenza vaccine was administered to all children without any serious adverse effects. Protective titer rates (proportion of patients achieving antibody titers >= 40 among those with pre-vaccination titers < 40) and response rates (proportion of patients with fourfold or more antibody rise) were 72% and 65% for H1N1, 60% and 40% for H3N2, and 38% and 46% for influenza B, respectively. However, patients on chemotherapy showed a significantly lower immune response to influenza A than those having completed chemotherapy; protection titer rates were 42% versus 90% for H1N1 (P=0.006) and 25% versus 83% for H3N2 (P=0.019). For influenza B, patients with low IgG showed a lower response rate than those with high IgG (29% vs. 61%, P=0.040). Multivariate analysis revealed that factors significantly associated with a lower immune response were low IgG (P < 0.001) and administration of chemotherapy (P=0.003) for H1N1, administration of chemotherapy (P=0.008) for H3N2, and low white blood cell (WBC) count (P=0.030) and low IgG (P=0.030) for influenza B. Conclusions. Influenza vaccination given to children with cancer was safe and induced immune reaction comparable to healthy children, although patients on chemotherapy and/or with chemotherapy-related conditions had a limited ability to produce a sufficient immune response.