Vaccines for prophylaxis of viral infections in patients with hematological malignancies

Cheuk, Dkl; Chiang, Alan Kwok Shing; Lee, Tsz Leung; Chan, Godfrey Chi-Fung; Ha, Shau Yin; Lau, Yu Lung

doi:10.1002/14651858.cd006505

Cited by 16 publications

(19 citation statements)

References 58 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Deferring vaccination may not be practical, e.g. seasonal flu vaccination, and may still have some efficacy (Schmid et al, 1981;Cheuk et al, 2011).…”

Section: Infection and Immunity In Myelomamentioning

confidence: 99%

Guidelines for screening and management of late and long‐term consequences of myeloma and its treatment

et al. 2017

View full text Add to dashboard Cite

SummaryA growing population of long-term survivors of myeloma is now accumulating the 'late effects' not only of myeloma itself, but also of several lines of treatment given throughout the course of the disease. It is thus important to recognise the cumulative burden of the disease and treatment-related toxicity in both the stable and active phases of myeloma, some of which is unlikely to be detected by routine monitoring. We summarise here the evidence for the key late effects in long-term survivors of myeloma, including physical and psychosocial consequences (in Parts 1 and 2 respectively), and recommend the use of late-effects screening protocols in detection and intervention. The early recognition of late effects and effective management strategies should lead to an improvement in the management of myeloma patients, although evidence in this area is currently limited and further research is warranted.Keywords: myeloma, late effects, quality of life, haematopoietic stem cell transplantation, chemotherapy. MethodologyThese guidelines were developed using the following stages:• Review of key literature from 1 April 2006 to 31 March 2016 using the Cochrane database (search term: myeloma) and Medline: search terms used were [myeloma] + late effects, long term effects, frailty, geriatric assessment, infection, infection prophylaxis, vaccination, nutrition, exercise, rehabilitation, employment, endocrine, disability, late treatment consequences, cancer survivorship (for all papers); and psychological, fatigue, second primary malignancy, quality of life, infection (reviews). As organ-specific areas, such as renal and bone, have been covered in previous guidelines, searches were not re-performed.• Development of key recommendations based on randomised, controlled trial evidence. In the absence of randomised data, recommendations were developed on the basis of literature review and a consensus of expert opinion.• Updating of the levels of evidence and grades of recommendation using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) nomenclature for assessing the quality of evidence and providing strength of recommendations (Appendix; http:// www.gradeworkinggroup.org/index.htm).• Review of the manuscript was performed by the British Society for Haematology (BSH) Guidelines Committee and Haemato-Oncology Task Force, and the BSH sounding board, comprised of 50 or more members of the BSH who have reviewed this Guidance and commented on its content and applicability in the UK setting, consistent with the primary target audience of UK-based multidisciplinary clinical teams treating myeloma and its complications. Involvement of patient perspectives was through Myeloma UK.• In preparing these guidelines, the authors have considered overall cost-effectiveness and budget impact of recommended interventions as well as clinical efficacy data and the burden/impact on patients. Formal health economic assessments have not been carried out.

show abstract

“…Deferring vaccination may not be practical, e.g. seasonal flu vaccination, and may still have some efficacy (Schmid et al, 1981;Cheuk et al, 2011).…”

Section: Infection and Immunity In Myelomamentioning

confidence: 99%

Guidelines for screening and management of late and long‐term consequences of myeloma and its treatment

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Existing data on influenza vaccine responses in MM patients are limited but suggest low HAI titers with seroprotection rates of less than 20% following standard flu vaccination 8,13–15 . One potential approach to enhancing the immune efficacy of a vaccine is the administration of a booster dose.…”

Section: Introductionmentioning

confidence: 99%

Clinical and Serologic Responses After a Two-dose Series of High-dose Influenza Vaccine in Plasma Cell Disorders: A Prospective, Single-arm Trial

Branagan

Duffy

Albrecht

et al. 2017

Clinical Lymphoma Myeloma and Leukemia

View full text Add to dashboard Cite

MicroAbstract The goal of the present study was to evaluate a novel prospective influenza vaccination strategy in patients with plasma cell disorders. Fifty-one patients were treated with a two dose series of high-dose inactivated trivalent influenza vaccine. This vaccination strategy was well tolerated led to very high rates of seroprotection against influenza. Background Patients with multiple myeloma (MM) and other plasma cell disorders are highly susceptible to influenza infections, which are major causes of morbidity in this population despite routine administration of seasonal influenza vaccination. Existing data are limited by small and retrospective studies, which suggest poor seroprotection rates of less than 20% following standard influenza vaccination in MM. Methods Patients with plasma cell dyscrasia (N=51) were treated with a two dose series of high-dose inactivated trivalent influenza vaccine over the 2014–2015 influenza season. Laboratory-confirmed influenza infections were identified through seasonal surveillance, sera were collected for influenza hemagglutination inhibition (HAI) titer assays, and logistic regression models were used to identify clinical correlates of HAI serologic responses. Findings Influenza vaccine was well tolerated without any vaccine-related ≥grade two adverse events. Only three patients (6%) experienced laboratory-confirmed influenza. Rates of HAI seroprotection against all three vaccine strains (influenza B, H1N1, and H3N2) increased from 4% at baseline to 49% and 65% following one and two doses, respectively. Risk factors associated with lower likelihood of HAI serologic response included plasma cell disorder requiring therapy, disease response assessment < partial response, or active conventional chemotherapy. Alternatively, active therapy with an immunomodulatory drug alone or with proteasome inhibitor was associated with a higher likelihood of HAI serologic response. Conclusions These data demonstrate that in contrast to historically poor results with standard influenza vaccination, this novel high-dose booster vaccination strategy leads to high rates of seroprotection. Randomized controlled studies are needed to compare this to standard vaccination strategy.

show abstract

“…Additionally, it is recommended that patients undergoing treatment of leukemia and lymphoma are vaccinated because it may reduce the risk of hospitalization for respiratory illness. [92][93][94][95] Ideally, vaccine should be administered at least 2 weeks before any cytotoxic therapy. For HCT recipients, vaccination of patients less than 6 months after transplant is ineffective and is generally not recommended.…”

Section: Community Respiratory Virusesmentioning

confidence: 99%

Viral Pneumonia in Patients with Hematopoietic Cell Transplantation and Hematologic Malignancies

Green

2017

Clinics in Chest Medicine

View full text Add to dashboard Cite

Viral pneumonia is a common complication for patients with hematologic malignancies and after hematopoietic cell transplantation causing significant morbidity, and often mortality. Infections are predominantly caused by herpes viruses, either by reactivation of latent infection, or less commonly primary infection, or community respiratory viruses. High-resolution CT scan is useful for diagnosis but is nonspecific; generally, bronchoalveolar lavage is required. Prevention strategies are not pathogen-specific but include vaccination, chemoprophylaxis, preemptive treatment, and effective infection-prevention strategies during community outbreaks. Directed antiviral treatment is available for some pathogens. Toxicities and viral resistance are perennial challenges.

show abstract

Vaccines for prophylaxis of viral infections in patients with hematological malignancies

Cited by 16 publications

References 58 publications

Guidelines for screening and management of late and long‐term consequences of myeloma and its treatment

Guidelines for screening and management of late and long‐term consequences of myeloma and its treatment

Clinical and Serologic Responses After a Two-dose Series of High-dose Influenza Vaccine in Plasma Cell Disorders: A Prospective, Single-arm Trial

Viral Pneumonia in Patients with Hematopoietic Cell Transplantation and Hematologic Malignancies

Contact Info

Product

Resources

About