a Department of Public Health; Osaka City University Graduate School of Medicine; Osaka, Japan.
Hum Vaccin Immunother. 2014;10(8):2387-94. doi: 10.4161/hv.29094.
Patients with hematological malignancies have high risk for morbidity and mortality from influenza. This study was conducted to evaluate the immunogenicity and reactogenicity of an influenza A(H1N1)pdm09 vaccine among such subjects. Fifty subjects were vaccinated twice during the 2009-2010 season. The antibody response was expressed in terms of mean fold rise (MFR) of geometric mean titer, seroresponse proportion (sR), and seroprotection proportion (sP). The first vaccination induced only a small response, and additional antibody was acquired after the second dose (MFR 2.3 and 3.9, sR 32% and 54%, and sP 30% and 48% after the first and the second vaccination, respectively). Rituximab treatment showed an especially inhibitory effect (MFR 1.3, sR 9% and sP 0%). When analyzed using logistic regression models, only rituximab was found to have an independent effect; the adjusted odds ratio for sR was 0.09 (P = 0.05). Influenza vaccination of patients with hematological malignancies resulted in adepuate response, and the second vaccination induced additional antibody. It is therefore recommended to vaccinate this group twice.
血液恶性肿瘤患者流感发病率和死亡率高。本研究旨在评估甲型 H1N1pdm09 流感疫苗在该人群中的免疫原性和反应原性。50 例患者在 2009-2010 季节期间接受了两次接种。抗体反应以几何平均滴度的平均倍数升高（MFR）、血清反应比例（sR）和血清保护比例（sP）表示。第一次接种仅引起较小的反应，第二次接种后获得了额外的抗体（第一次和第二次接种后的 MFR 分别为 2.3 和 3.9，sR 分别为 32%和 54%，sP 分别为 30%和 48%）。利妥昔单抗治疗显示出特别的抑制作用（MFR 为 1.3，sR 为 9%，sP 为 0%）。使用逻辑回归模型进行分析时，只有利妥昔单抗具有独立作用；sR 的调整比值比为 0.09（P = 0.05）。血液恶性肿瘤患者的流感疫苗接种可产生足够的反应，第二次接种可诱导额外的抗体。因此，建议对该人群进行两次接种。
