Influenza and pneumococcal vaccination in hematological malignancies: a systematic review of efficacy, effectiveness and safety

Abstract

BackgroundThe 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.ObjectiveTo assess flu and pneumococcal vaccinations efficacy, effectiveness, and safety in onco-hematological patients.MethodsTwo 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.Results22 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.ConclusionDespite 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.

Infectious events and associated risk factors in mycosis fungoides/Sézary syndrome: a retrospective cohort study

“…Nevertheless, this descriptive analysis allows us to propose preventive measures that would be useful for patients with MF/SS, and especially those with previously identified risk factors (SS diagnosis, lymphocyte count < 0·5 × 10 9 cells L −1 and/or chronic organ failure). To prevent bacterial pneumonia, pneumococcal vaccination should be performed in patients with stage ≥ IB disease, as this vaccination is known to be worthwhile for patients with haematological malignancies, with few or no side‐effects . Although influenza infections were not recorded in our study, as they are mostly managed without hospital referral, influenza vaccination could also be proposed, as this vaccination is both useful and effective in oncohaematological patients .…”

“…To prevent bacterial pneumonia, pneumococcal vaccination should be performed in patients with stage ≥ IB disease, as this vaccination is known to be worthwhile for patients with haematological malignancies, with few or no side‐effects . Although influenza infections were not recorded in our study, as they are mostly managed without hospital referral, influenza vaccination could also be proposed, as this vaccination is both useful and effective in oncohaematological patients . Prophylaxis with co‐trimoxazole and valaciclovir should be initiated with CD4 count below < 0·2 × 10 9 cells L −1 .…”

Szczepienia ochronne u dorosłych chorych na nowotwory hematologiczne oraz u chorych z asplenią – zalecenia PTHiT i sekcji do spraw zakażeń PALG

“…Listę szczepionek żywych przedstawiono w tabeli III. [36,38]. Odpowiedź na szczepienia w ciągu 6 miesięcy od zakończenia leczenia rytuksymabem jest bliska zeru [40,41].…”

Response to pneumococcal vaccination in multiple myeloma

“…The risk of infections decreases in MM patients responding to treatment, but increases again, when disease progression or relapse occurs . Current guidelines for individuals undergoing stem cell transplant recommend the use of pneumococcal vaccination and penicillin A prophylaxis to prevent pneumococcal infection and whether these treatments are beneficial to MM patients is currently unclear.…”