Pedrazzoli P, Baldanti F, Donatelli I, Castrucci M R, Puglisi F, Silvestris N, Cinieri S
Division of Medical Oncology, Department of Hemato-oncology
Molecular Virology Unit, Virology, Department of Microbiology, IRCCS Policlinico 'San Matteo' Foundation, Pavia.
Ann Oncol. 2014 Jun;25(6):1243-7. doi: 10.1093/annonc/mdu114. Epub 2014 Mar 11.
Influenza virus causes annual epidemics in the winter-spring season with significant morbidity in the general population and important mortality in high-risk groups, including cancer patients. Opinions on the suitability of patients with malignancies not undergoing active treatment and in different phases of antineoplastic therapy, to receive influenza vaccination, vary considerably among oncologists, sometimes even within one center.
We reviewed available data, including recommendations by national health authorities, on impact of influenza in patients with cancer and their capacity to mount protective immunological responses to vaccination, thus allowing, on behalf of Italian Association of Medical Oncology, to make suitable recommendations for the prevention and treatment of seasonal influenza.
Patients with cancer often have disease- or treatment-related immunosuppression, and as a consequence, they may have a suboptimal serologic response to influenza vaccination. The protective effect of the different preparations of influenza vaccines in patients with cancer has not been widely investigated, especially in adult patients harboring solid tumors. The optimal timing for administration of influenza vaccines in patients receiving chemotherapy is also not clearly defined. However, since vaccination is the most effective method, along with antiviral drugs in selected patients, for preventing influenza infection, it has to be recommended for cancer patients. Implementing vaccination of close contacts of oncology patients would be an additional tool for enhancing protection in fragile patient populations.
流感病毒在冬春季节引发年度流行，在普通人群中导致显著发病，在包括癌症患者在内的高危人群中造成重要死亡。对于未接受积极治疗以及处于抗肿瘤治疗不同阶段的恶性肿瘤患者是否适合接种流感疫苗，肿瘤学家之间的意见差异很大，有时甚至在同一中心内也存在分歧。
我们回顾了现有数据，包括国家卫生当局的建议，内容涉及流感对癌症患者的影响以及他们对疫苗接种产生保护性免疫反应的能力，从而代表意大利医学肿瘤学会就季节性流感的预防和治疗提出合适的建议。
癌症患者常因疾病或治疗导致免疫抑制，因此他们对流感疫苗的血清学反应可能欠佳。不同流感疫苗制剂对癌症患者的保护作用尚未得到广泛研究，尤其是在患有实体瘤的成年患者中。接受化疗的患者接种流感疫苗的最佳时机也尚未明确界定。然而，由于接种疫苗是预防流感感染最有效的方法，与抗病毒药物一起用于特定患者，因此必须向癌症患者推荐接种。对肿瘤患者的密切接触者实施疫苗接种将是增强对脆弱患者群体保护的又一手段。
