Immune response after influenza vaccination in children with cancer.
OBJECTIVE
To assess the immune response to inactivated trivalent split influenza vaccine in children with cancer.


METHODS
Forty-four children with various types of malignancies received two doses of influenza vaccine 2-4 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 > or =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.
Matsuzaki
Akinobu
A
Division of Child Health, School of Health Sciences, Kyushu University, Fukuoka, Japan. matsuzaki@shs.kyushu-u.ac.jp
Suminoe
Aiko
A
Koga
Yuhki
Y
Kinukawa
Naoko
N
Kusuhara
Koichi
K
Hara
Toshiro
T
D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood; D000917:Antibody Formation / Q000187:drug effects; D000970:Antineoplastic Agents / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology; D053122:Influenza A Virus, H3N2 Subtype / Q000276:immunology; D009980:Influenza A virus / Q000276:immunology; D009981:Influenza B virus / Q000276:immunology; D007252:Influenza Vaccines / Q000276:immunology*; D009369:Neoplasms / Q000150:complications / Q000628:therapy*; D014611:Vaccination / Q000379:methods
D000914:Antibodies, Viral; D000970:Antineoplastic Agents; D007074:Immunoglobulin G; D007252:Influenza Vaccines