Immunologic consequences of chemotherapy for ovarian cancer: Impaired responses to the influenza vaccine
Immunologic consequences of chemotherapy for ovarian cancer: Impaired responses to the influenza vaccine
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DOI：
10.1016/j.vaccine.2013.09.001
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发表时间：
2013-11-04
期刊：
影响因子：
5.5
通讯作者：
Sullivan, Kathleen E.
中科院分区：
文献类型：
--
作者：
Chu, Christina S.;Boyer, Jean D.;Sullivan, Kathleen E.
目的：研究卵巢癌化疗对免疫功能的影响，并确定对流感疫苗的血清学反应的影响：根据IRB批准的协议，卵巢癌患者给予季节性三价灭活流感疫苗。采集外周血用于免疫学评估。分析血清的血凝抑制（HAI）抗体滴度。外周血单个核细胞进行分离，以表征T和B细胞群体和functions.Results：31例患者招募：13在缓解接受树突状细胞疫苗或没有一个单一剂量的低剂量环磷酰胺，3在缓解不接受治疗，和15接受标准治疗。观察到对T细胞和B细胞亚群分布的显著影响。还观察到功能性影响。很少有患者能够产生4倍HAI抗体应答。在20%中观察到HI NI的4倍应答，在26%中观察到H3N2的4倍应答，在6%中观察到流感B的4倍应答。预先存在的暴露于流感是预测responders.Conclusions：尽管CDC的建议，接受化疗的患者接受流感疫苗，很少有证据支持其血清学的有效性，在这一人群。卵巢癌患者几乎都不能产生有意义的抗体反应。这些发现对未来季节性和新型大流行性流感爆发的资源分配具有重要意义，了解化疗导致的免疫缺陷可能会改善患者护理。(C)2013爱思唯尔有限公司保留所有权利。
Objectives: To examine the effect of chemotherapy for ovarian cancer on immunologic function and to define the effect on the serologic response to the influenza vaccine.Methods: Under IRB approved protocols, patients with ovarian cancer were administered seasonal trivalent killed influenza vaccines. Peripheral blood was collected for immunologic assessments. Serum was analyzed for hemagglutination inhibition (HAI) antibody titers. Peripheral blood mononuclear cells were isolated to characterize T and B cell populations and function.Results: Thirty-one patients were recruited: 13 in remission receiving a dendritic cell vaccine with or without a single dose of low-dose cyclophosphamide, 3 in remission not receiving treatment, and 15 undergoing standard therapy. Significant effects on T cell and B cell subset distributions were seen. Functional effects were also seen. Few patients were able to mount a 4-fold HAI antibody response. A 4-fold response was observed for HI NI in 20%, for H3N2 in 26%, and for influenza B in 6%. Pre-existing exposure to influenza was predictive of responders.Conclusions: Despite CDC recommendations that patients undergoing chemotherapy receive influenza vaccine, there is little evidence to support its serologic effectiveness in this population. Patients with ovarian cancer are almost uniformly unable to mount a meaningful antibody response. These findings have serious implications for future resource allocation for both seasonal and novel pandemic influenza outbreak and understanding the immunologic deficits as a result of chemotherapy may improve patient care. (C) 2013 Elsevier Ltd. All rights reserved.