title: Immunogenicity of an inactivated monovalent 2009 influenza A (H1N1) vaccine in patients who have cancer.
abstract: BACKGROUND
  The immune response of patients who have cancer, who may be receiving immunosuppressive therapy, is generally considered to be decreased. This study aimed to evaluate the immune response of cancer patients to the 2009 influenza A (H1N1) vaccine.
  
  
  METHODS
  We conducted a prospective single site study comparing the immune response after H1N1 vaccination of healthy controls (group A), patients who had solid tumors and were taking myelosuppressive chemotherapy (group B), patients who had solid tumors and were taking nonmyelosuppressive or no treatment (group C), and patients who had hematologic malignancies (group D).
  
  
  RESULTS
  At 2-6 weeks after vaccination, seroconversion was observed in 80.0% of group A (95% confidence interval [CI], 65.0%-89.7%), 72.2% of group B (95% CI, 55.9%-84.3%), 87.0% of group C (95% CI, 72.2%-94.7%), and 75.0% of group D (95% CI, 52.8%-89.2%) (p = NS). The geometric mean titer ratio, that is, geometric mean factor increase in antibody titer after vaccination, was 12.6 (95% CI, 7.9-19.9), 12.7 (95% CI, 7.3-22.1), 23.0 (95% CI, 13.9-38.2), and 12.1 (95% CI, 5.3-27.9) (p = NS), and the seroprotection rates were 95.5% (95% CI, 84.0%-99.6%), 79.0% (95% CI, 63.4%-89.2%), 90.5% (95% CI, 77.4%-96.8%), and 90.0% (95% CI, 71%-98.7%) in the corresponding groups (p = NS). Immune responses were robust regardless of malignancy, or time intervals between the use of myelosuppressive or immunosuppressive medications and vaccination. No participants developed clinical H1N1 infection.
  
  
  CONCLUSIONS
  Cancer patients, whether taking myelosuppressive chemotherapy or not, are able to generate an immune response to the H1N1 vaccine similar to that of healthy controls.
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, Maimonides Medical Center, 6300 8 Avenue, Brooklyn, New York 11220, USA. yxu@maimonidesmed.org
authors.forename: Yiqing
authors.initials: Y
authors.lastname: Xu
authors.forename: Nanda
authors.initials: N
authors.lastname: Methuku
authors.forename: Praveena
authors.initials: P
authors.lastname: Coimbatore
authors.forename: Theresa
authors.initials: T
authors.lastname: Fitzgerald
authors.forename: Yiwu
authors.initials: Y
authors.lastname: Huang
authors.forename: Ying-Yi
authors.initials: YY
authors.lastname: Xiao
authors.forename: Murali
authors.initials: M
authors.lastname: Pagala
authors.forename: Shachi
authors.initials: S
authors.lastname: Gupta
authors.forename: William
authors.initials: W
authors.lastname: Solomon
authors.forename: Philip
authors.initials: P
authors.lastname: Rubin
authors.forename: John
authors.initials: J
authors.lastname: Treanor
authors.forename: Alan
authors.initials: A
authors.lastname: Astrow
authors.forename: Howard
authors.initials: H
authors.lastname: Minkoff
authors.forename: Jay S
authors.initials: JS
authors.lastname: Cooper
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000276:immunology*; D011446:Prospective Studies
chemical_list: D007252:Influenza Vaccines