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三价灭活流感疫苗在急性白血病儿童中的有效性

The Effectiveness of Trivalent Inactivated Influenza Vaccine in Children with Acute Leukemia.

作者信息

Sykes April, Gerhardt Elsie, Tang Li, Adderson Elisabeth E

机构信息

Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN.

Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN.

出版信息

J Pediatr. 2017 Dec;191:218-224.e1. doi: 10.1016/j.jpeds.2017.08.071.

Abstract

OBJECTIVE

The objective of this study was to determine the effectiveness of trivalent inactivated influenza vaccine (TIV) for the prevention of laboratory-confirmed influenza and influenza-like illnesses (ILI) among children and adolescents receiving therapy for acute leukemia.

STUDY DESIGN

A retrospective review of the demographic and clinical characteristics of 498 patients at a pediatric cancer center who received therapy for acute leukemia during 3 successive influenza seasons (2010-2011 through 2012-2013).

RESULTS

In 498 patient seasons with a known immunization history (median age, 6 years; range, 1-21), 354 patients (71.1%) were immunized with TIV and 98 (19.7%) received a booster dose of vaccine. Vaccinated and unvaccinated patients had generally similar demographic characteristics. There were no differences in the overall rates of influenza or ILI between vaccinated and unvaccinated patients overall, or in any individual season. There was no difference in the rates of influenza or ILI between patients who received 1 dose of vaccine and those who received 2 doses. Time to first influenza infection and time to first ILI in vaccinated and unvaccinated patients were not different.

CONCLUSION

TIV did not protect children and adolescents with acute leukemia against laboratory-confirmed influenza or ILI. Future prospective studies should assess TIV effectiveness in high-risk subpopulations and alternative strategies to prevent influenza should be considered in this population.

摘要

目的

本研究的目的是确定三价灭活流感疫苗(TIV)在预防接受急性白血病治疗的儿童和青少年实验室确诊流感及流感样疾病(ILI)方面的有效性。

研究设计

对一家儿科癌症中心在连续3个流感季节(2010 - 2011年至2012 - 2013年)接受急性白血病治疗的498例患者的人口统计学和临床特征进行回顾性分析。

结果

在498个有已知免疫史的患者季节(中位年龄6岁;范围1 - 21岁)中,354例患者(71.1%)接种了TIV,98例(19.7%)接受了疫苗加强剂量。接种疫苗和未接种疫苗的患者总体人口统计学特征相似。在总体上以及任何一个单独季节中,接种疫苗和未接种疫苗的患者之间流感或ILI的总体发生率均无差异。接受1剂疫苗和接受2剂疫苗的患者之间流感或ILI的发生率也无差异。接种疫苗和未接种疫苗的患者首次感染流感的时间和首次发生ILI的时间没有差异。

结论

TIV不能保护患有急性白血病的儿童和青少年预防实验室确诊的流感或ILI。未来的前瞻性研究应评估TIV在高危亚人群中的有效性,并且应考虑针对该人群预防流感的替代策略。

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