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Influenza immunization of children with neoplastic diseases
Author(s) -
Steinherz Peter G.,
Brown Arthur E.,
Gross Peter A.,
Braun David,
Ghavimi Fereshteh,
Wollner Norma,
Rosen Gerald,
Armstrong Donald,
Miller Denis R.
Publication year - 1980
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19800215)45:4<750::aid-cncr2820450423>3.0.co;2-z
Subject(s) - medicine , titer , chemotherapy , neutropenia , influenza vaccine , immunization , antigen , immunology , vaccination , gastroenterology , antibody
During the National Influenza Immunization Program in 1976, 147 children with neoplastic diseases received Wyeth split‐product bivalent influenza vaccine: A/New Jersey/8/76 (Hsw 1 N 1 ), A/Victoria/3/75 (H 3 N 2 ). Thirteen normal siblings served as controls. Seventy‐one patients received two doses of the vaccine four weeks apart. After the second injection of A/NJ/8/76, there was a difference between the response of the patients on chemotherapy and those off therapy ⩾30 days—38% vs. 76%, P < 0.01 for four‐fold rise and 26% vs. 57%, P < 0.05 for the attainment of protective (⩾32) hemagglutination inhibition (HI) titers. These differences were observed in both leukemia‐lymphoma and solid tumor patients. There was a difference in HI titers to A/Vic/75 between patients on and off chemotherapy after a single injection, 34% vs. 71%, P < 0.001 for a four‐fold rise. After the second immunization, only 52% on, and 86% off therapy (P < 0.05) had a four‐fold rise in titers. Thirty‐two percent of the patients on treatment who achieved “protective” titers did so only after the second immunization. Immunoglobulin levels and neutropenia did not correlate with the inability to obtain a four‐fold rise in titers. Our findings suggest that patients on chemotherapy cannot be effectively vaccinated by a new antigen, and that single yearly boosters may be insufficient for recall of old antigens. Patients off chemotherapy ⩾30 days respond as normal controls. Cancer 45:750‐756, 1980.