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Novel flu vaccine strategy improves protection for oncology patients
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High-dose influenza vaccine with a second booster dose administered to patients with plasma cell disorders reduced influenza infections by approximately 14%, according to researchers from Yale.
Patients with plasma cell disorders (PCDs) such as multiple myeloma are among those at greatest risk for serious illness from common infections and face an influenza infection rate of at least 20%, the researchers said. Moreover, rates of achieving protective levels of hemagglutination antibody inhibition (HAI) titers in PCD patients immunized with a standard dose (SD) of influenza vaccine range from 5% to 19%, stressing the need for improved vaccination strategies.
Andrew R. Branagan, MD, postdoctoral associate in medicine at Yale School of Medicine, and colleagues evaluated a strategy of administering two doses of Fluzone high-dose (HD) influenza vaccine (Sanofi Pasteur) to PCD patients 30 days apart during the 2014-2015 influenza season. The study included 51 patients (median age, 65 years), all of whom received the two doses of HD vaccine. The primary endpoint was the rate of laboratory-confirmed influenza. The researchers also compared rates of seroprotection measured by HAI titers.
The two-dose strategy was safely tolerated by PCD patients, the researchers said. Two patients developed laboratory-confirmed influenza during the season. Preliminary data from 30 multiple myeloma patients showed that only 4% had protective HAI titers to all three seasonal influenza strains at baseline. The rate of seroprotective HAI after a single dose of HD vaccine was 49%, and the rate of seroconversion after the second HD dose vaccine was 66% — the highest reported serologic response rate in this population.
Branagan and colleagues said the rate of laboratory-confirmed influenza infection was 6% compared with the expected rate of 20%, suggesting the novel two-dose vaccination strategy was both safe and offers a clinical benefit to patients with PCD.
“Using an approved flu vaccine in a novel dosing schedule yielded promising results for a group of patients at high risk for infection,” Branagan said in a press release. “We hope to confirm these results in a larger prospective randomized trial that is underway now at Yale during the 2015-2016 flu season. We suspect this strategy could benefit other cancer patient populations.” – by John Schoen
Reference:
Branagan AR, et al. Abstract 3058. Presented at: American Society of Hematology Annual Meeting and Exposition; Dec. 5-8, 2015; Orlando, Florida.
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