Ring, A., Marx, G., Steer, C., & Harper, P. (2002). Influenza vaccination and chemotherapy: A shot in the dark? Supportive Care in Cancer, 10, 462–465.

DOI Link

Purpose

To evaluate influenza vaccination in patients with cancer

Search Strategy

DATABASES USED: PubMed from 1992–2002, using influenza, vaccination, immunization, cancer, and malignancy as search terms; no restrictions were placed on the language of the publications. Additional data were acquired by direct communication with vaccine manufacturers.

Sample Characteristics

FINAL NUMBER STUDIES INCLUDED = 11 studies measuring seroconversion after influenza vaccination

KEY SAMPLE CHARACTERISTICS: No comments existed regarding the research design of the studies, but five studies included a control group.

Results

Seroconversion rates following influenza vaccination ranged from 10%–78% in patients with cancer as compared with 56%–94% in healthy controls. Seroconversion rates following influenza vaccination ranged from 37%–52% in patients with cancer on chemotherapy as compared with 76%–92% of patients with cancer not receiving chemotherapy. One study of 42 adult patients with hematologic or oncologic disorders found that the seroconversion rate following influenza vaccination was 50% if the vaccine was given at the time of chemotherapy, compared with 93% if the vaccine was given between cycles.

Conclusions

Serologic responses to different viral antigens may vary considerably within individual patients. Responses to vaccination often are inferior to those seen in historic healthy controls. Immunocompromise resulting from tumor type (hematologic malignancy versus solid tumors) or treatment (standard chemotherapy versus stem cell transplantation) may correlate with efficacy of the vaccination. Patients with hematologic malignancies or stem cell transplant recipients may have an inferior response to vaccination. The timing of vaccination with respect to chemotherapy may be critical.

Limitations

  • The studies found in the literature search were characterized by small sample sizes and an absence of stratification for tumor type, stage, chemotherapy schedule, vaccination type, or immune function.

Legacy ID

2653