Humoral and cellular immune responses after influenza vaccination in patients with postcancer fatigue

Abstract

The aim of this study was to compare humoral and cellular immune responses to influenza vaccination in cancer survivors with and without severe symptoms of fatigue. Severely fatigued (n D 15) and non-fatigued (n D 12) diseasefree cancer survivors were vaccinated against seasonal influenza. Humoral immunity was evaluated at baseline and post-vaccination by a hemagglutination inhibition assay. Cellular immunity was evaluated at baseline and postvaccination by lymphocyte proliferation and activation assays. Regulatory T cells were measured at baseline by flow cytometry and heat-shock protein 90 alpha levels by ELISA. Comparable humoral immune responses were observed in fatigued and non-fatigued patients, both pre-and post-vaccination. At baseline, fatigued patients showed a significantly diminished cellular proliferation upon virus stimulation with strain H3N2 (1414 § 1201 counts), and a trend in a similar direction with strain H1N1 (3025 § 2339 counts), compared to non-fatigued patients (3099 § 2401 and 5877 § 4604 counts, respectively). The percentage of regulatory T lymphocytes was significantly increased (4.4 § 2.1% versus 2.4 § 0.8%) and significantly lower amounts of interleukin 2 were detected prior to vaccination in fatigued compared to non-fatigued patients (36.3 § 44.3 pg/ml vs. 94.0 § 45.4 pg/ml with strain H3N2 and 28.4 § 44.0 pg/ml versus 74.5 § 56.1 pg/ml with strain H1N1). Pre-vaccination heat-shock protein 90 alpha concentrations, postvaccination cellular proliferation, and post-vaccination cytokine concentrations did not differ between both groups. In conclusion, influenza vaccination is favorable for severely fatigued cancer survivors and should be recommended when indicated. However, compared to non-fatigued cancer survivors, fatigued cancer survivors showed several significant differences in immunological reactivity at baseline, which warrants further investigation.

Prostate Cancer Survivors Present Long-Term, Residual Systemic Immune Alterations

“…Although, in the absence of a suitable control group not treated with radiotherapy it cannot be evaluated with certainty which immune changes are due to radiation effects or due to the malignant condition itself. Within the literature there are very few reports on the long-term follow-up of the immune status of cancer survivors and the detected immune alterations were attributed to both cancer itself and treatment-related long-term consequences [90][91][92].…”