title: Serum antibody response to influenza virus vaccination during chemotherapy treatment in adult patients with solid tumours.
abstract: BACKGROUND
  Higher rates of hospitalization and mortality are described in oncology patients with influenza virus infection compared to the general population. Yearly influenza vaccination is recommended for patients treated with chemotherapy. The optimal moment to administer the vaccine during a treatment cycle has not been studied extensively.
  
  
  METHODS
  During the influenza season 2011-2012 we conducted a multicenter randomized controlled trial (OFLUVAC, NTR2858, no sponsoring) in the Netherlands. Patients receiving adjuvant chemotherapy for breast or colorectal cancer were randomized between early (day 5 after chemotherapy) and late (day 16 after chemotherapy) vaccination with the influenza virus vaccine (Influvac(®) 2011/2012-Vaxigrip(®) 2011/2012). Influenza virus-specific antibody titres were determined before, 3 and 12 weeks after vaccination by haemagglutination inhibition.
  
  
  RESULTS
  Thirty-eight breast cancer patients (early=21; late=17) and 18 colorectal cancer patients (early=8; late=10) were analyzed. In breast cancer patients overall serologic responses were adequate. A statistically significant higher response in patients who received early compared to late vaccination in the chemotherapy cycle was observed. Geometric mean titres post vaccination on day 5 versus day 16 were 69.3 versus 27.4 (H3N2), 76.4 versus 17.5 (H1N1) and 34.4 versus 26.0 (B/Brisbane), respectively. In colorectal cancer patients overall serologic responses were adequate, no significant difference was found between early and late vaccination. Geometric mean titres post vaccination on day 5 versus day 16 were 170.1 versus 192.4 (H3N2), 233.0 versus 280.8 (H1N1) and 62.6 versus 75.9 (B/Brisbane), respectively.
  
  
  CONCLUSIONS
  Overall antibody response to the influenza virus vaccine in patients treated with chemotherapy for breast or colorectal cancer patients is adequate. Breast cancer patients seem to mount the best antibody response when vaccinated early after a chemotherapy cycle (≤day 5). No difference was found between early and late vaccination in colorectal cancer patients.
authors.affiliation: Department of Internal Medicine, Tergooi Hilversum/Blaricum,Tergooi Hilversum, PO Box 10016, 1201 DA Hilversum, The Netherlands. Electronic address: Mwumkes@tergooi.nl.
authors.forename: M L
authors.initials: ML
authors.lastname: Wumkes
authors.forename: A M T
authors.initials: AM
authors.lastname: van der Velden
authors.forename: M
authors.initials: M
authors.lastname: Los
authors.forename: M B L
authors.initials: MB
authors.lastname: Leys
authors.forename: A
authors.initials: A
authors.lastname: Beeker
authors.forename: M R
authors.initials: MR
authors.lastname: Nijziel
authors.forename: A W G
authors.initials: AW
authors.lastname: van der Velden
authors.forename: M
authors.initials: M
authors.lastname: Westerman
authors.forename: A
authors.initials: A
authors.lastname: Meerveld-Eggink
authors.forename: G F
authors.initials: GF
authors.lastname: Rimmelzwaan
authors.forename: G T
authors.initials: GT
authors.lastname: Rijkers
authors.forename: D H
authors.initials: DH
authors.lastname: Biesma
mesh_terms: D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000276:immunology; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000276:immunology; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000276:immunology*; D007251:Influenza, Human / Q000276:immunology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D044967:Serum / Q000276:immunology; D014611:Vaccination / Q000379:methods*
chemical_list: D000914:Antibodies, Viral; D000970:Antineoplastic Agents; D007252:Influenza Vaccines
keywords: Chemotherapy; Influenza virus vaccination; Solid tumours