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Multiple‐dose granulocyte‐macrophage–colony‐stimulating factor plus 23‐valent polysaccharide pneumococcal vaccine in patients with chronic lymphocytic leukemia
Author(s) -
Safdar Amar,
Rodriguez Gilhen H.,
Rueda Adriana M.,
Wierda William G.,
Ferrajoli Alessandra,
Musher Daniel M.,
O'Brien Susan,
Koller Charles A.,
Bodey Gerald P.,
Keating Michael J.
Publication year - 2008
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/cncr.23561
Subject(s) - medicine , pneumococcal vaccine , pneumococcal polysaccharide vaccine , vaccination , immunology , streptococcus pneumoniae , reactogenicity , granulocyte macrophage colony stimulating factor , chronic lymphocytic leukemia , antibody , pneumococcal infections , leukemia , cytokine , immunization , microbiology and biotechnology , antibiotics , biology , pneumococcal disease
Abstract BACKGROUND. For the current study, the authors sought to determine whether administration of multiple‐dose granulocyte‐macrophage–colony‐stimulating factor (GM‐CSF) could improve response to standard 23‐valent polysaccharide pneumococcal vaccine (PPV) in patients with chronic lymphocytic leukemia (CLL). METHODS. Patients were allocated randomly to receive PPV either alone or with 3 doses of GM‐CSF (250 μg) given before or after vaccination. Serum was obtained before, 4 weeks after, and 12 weeks after vaccination for antibody determination. Thirty‐two patients with CLL were given PPV. They were randomized to receive 3 doses of GM‐CSF either before or after vaccination or to receive no GM‐CSF. RESULTS. A 4‐fold rise in immunoglobulin G (IgG) to capsular polysaccharides from Streptococcus pneumoniae types 4, 6B, 9V, 14, 19F, and 23F occurred in <10% of patients in each of the 3 groups. There were no differences in geometric mean IgG levels in any of the 3 groups 4 weeks or 12 weeks after vaccination. CONCLUSIONS. In patients with CLL, the response to pure polysaccharide pneumococcal vaccine was low despite immune enhancement with multiple doses of GM‐CSF. In all patients, reactogenicity was minor. Cancer 2008. © 2008 American Cancer Society.