Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Medicine, University of Washington School of Medicine, Seattle, Washington.
Department of Pediatrics, Seattle Children's Hospital/University of Washington School of Medicine, Seattle, Washington.
Biol Blood Marrow Transplant. 2019 Nov;25(11):e321-e330. doi: 10.1016/j.bbmt.2019.07.034. Epub 2019 Aug 5.
Until recently, measles exposures were relatively rare and so, consequently, were an afterthought for cancer patients and/or blood and marrow transplant recipients and their providers. Declines in measles herd immunity have reached critical levels in many communities throughout the United States due to increasing vaccine hesitancy, so that community-based outbreaks have occurred. The reemergence of measles as a clinical disease has raised serious concerns among immunocompromised patients and those who work within the cancer and hematopoietic cell transplantation (HCT) community. Since live attenuated vaccines, such as measles, mumps, and rubella (MMR), are contraindicated in immunocompromised patients, and with no approved antiviral therapies for measles, community exposures in these patients can lead to life-threatening infection. The lack of data regarding measles prevention in this population poses a number of clinical dilemmas. Herein specialists in Infectious Diseases and HCT/cellular therapy endorsed by the American Society of Transplant and Cellular Therapy address frequently asked questions about measles in these high-risk cancer patients and HCT recipients and provide expert opinions based on the limited available data.
直到最近，麻疹的暴露相对较少，因此对于癌症患者和/或血液和骨髓移植受者及其提供者来说，麻疹是事后才考虑的问题。由于疫苗犹豫情绪不断增加，麻疹群体免疫在美国许多社区的下降已经达到了临界水平，因此出现了基于社区的暴发。麻疹作为一种临床疾病的重新出现，引起了免疫功能低下患者以及癌症和造血细胞移植（HCT）社区工作人员的严重关注。由于活减毒疫苗（如麻疹、腮腺炎和风疹（MMR））在免疫功能低下患者中禁忌使用，并且麻疹没有批准的抗病毒疗法，因此这些患者中的社区暴露可能导致危及生命的感染。由于缺乏关于该人群麻疹预防的数据，因此存在许多临床难题。在此，美国移植和细胞治疗协会认可的传染病学和 HCT/细胞治疗专家针对这些高危癌症患者和 HCT 受者提出了关于麻疹的常见问题，并根据有限的可用数据提供了专家意见。
