title: Influenza and Pneumococcal Vaccination in Hematological Malignancies: a Systematic Review of Efficacy, Effectiveness, and Safety.
abstract: BACKGROUND
  The risk of getting influenza and pneumococcal disease is higher in cancer patients, and serum antibody levels tend to be lower in patients with hematological malignancy.
  
  
  OBJECTIVE
  To assess flu and pneumococcal vaccinations efficacy, effectiveness, and safety in onco-hematological patients.
  
  
  METHODS
  Two systematic reviews and possible meta-analysis were conducted to summarize the results of all primary study in the scientific literature about the flu and pneumococcal vaccine in onco-hematological patients. Literature searches were performed using Pub-Med and Scopus databases. StatsDirect 2.8.0 was used for the analysis.
  
  
  RESULTS
  22 and 26 studies were collected respectively for flu and pneumococcal vaccinations. Protection rate of booster dose was 30% (95% CI=6-62%) for H1N1. Pooled prevalence protection rate of H3N2 and B was available for meta-analysis only for first dose, 42.6% (95% CI=23.2 - 63.3 %) and 39.6 % (95% CI=26%-54.1%) for H3N2 and B, respectively. Response rate of booster dose resulted 35% (95% CI=19.7-51.2%) for H1N1, 23% (95% CI=16.6-31.5%) for H3N2, 29% (95% CI=21.3-37%) for B.
  
  
  CONCLUSIONS
  Despite the low rate of response, flu, and pneumococcal vaccines are worthwhile for patients with hematological malignancies. Patients undergoing chemotherapy in particular rituximab, splenectomy, transplant recipient had lower and impaired response. No serious adverse events were reported for both vaccines.
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: La Torre
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome.
authors.forename: Alice
authors.initials: A
authors.lastname: Mannocci
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome.
authors.forename: Vittoria
authors.initials: V
authors.lastname: Colamesta
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome.
authors.forename: Valeria
authors.initials: V
authors.lastname: D'Egidio
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome.
authors.forename: Cristina
authors.initials: C
authors.lastname: Sestili
authors.affiliation: Local Health Unit Roma 1.
authors.forename: Antonietta
authors.initials: A
authors.lastname: Spadea