Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Division of Allergy and Infectious Diseases, University of Washington, Seattle.
JAMA Netw Open. 2021 Jul 1;4(7):e2118508. doi: 10.1001/jamanetworkopen.2021.18508.
Although patients with cancer are at an increased risk of infection-related complications, few studies have characterized their vulnerability to measles and mumps. Given the recent outbreaks and increased community vaccine hesitancy, understanding measles and mumps immunity within this population is vital.
To identify a point prevalence estimate of protective measles and mumps antibodies among ambulatory patients with cancer.
DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, residual clinical plasma samples were obtained from consecutive patients with cancer at Seattle Cancer Care Alliance/Fred Hutchinson Cancer Research Center in Seattle, Washington, in August 2019. These samples were tested for measles and mumps IgG using a commercial enzyme-linked immunosorbent assay. Patients without cancer were excluded from the analysis.
Patient age, sex, self-reported race and ethnicity, primary disease, receipt of chemotherapy in the past 30 days before sample collection, hematopoietic cell transplant (HCT) history, and date of most recent intravenous immunoglobulin treatment were abstracted from electronic medical records.
Measles and mumps IgG seroprevalence, defined as the proportion of patients with positive antibody test results, was measured overall and among the subgroups.
Of the 959 patients included in the analysis, 510 (53%) were male individuals and the mean (SD) age at sample collection was 60 (15) years. Most patients (576 [60%]) had a malignant solid tumor, and 383 patients (40%) had a hematologic malignant neoplasm; 146 patients (15%) had an HCT history. Overall, the seroprevalence of measles antibodies was 0.75 (95% CI, 0.72-0.78), and the seroprevalence of mumps antibodies was 0.62 (95% CI, 0.59-0.65). The lowest seroprevalences were among patients with a hematologic malignant neoplasm (0.63 for measles and 0.48 for mumps), those with a history of HCT (0.46 for measles and 0.29 for mumps), and those aged 30 to 59 years (0.49-0.63 for measles and 0.41-0.58 for mumps).
In this study, 25% of ambulatory patients with cancer lacked protective antibodies for measles and 38% lacked protective antibodies for mumps. Deficits in protective antibodies underscore patients' increased risk during outbreaks and emphasize the need for community-based efforts to increase herd immunity to protect this population.
尽管癌症患者感染相关并发症的风险增加，但很少有研究描述他们对麻疹和腮腺炎的易感性。鉴于最近的疫情爆发和社区疫苗接种犹豫不决的情况，了解癌症患者中麻疹和腮腺炎的免疫情况至关重要。
确定门诊癌症患者保护性麻疹和腮腺炎抗体的现患率估计值。
设计、地点和参与者：在这项横断面研究中，于 2019 年 8 月从华盛顿州西雅图的西雅图癌症护理联盟/弗雷德·哈钦森癌症研究中心的连续癌症患者中获得剩余的临床血浆样本。使用商业酶联免疫吸附试验检测这些样本中的麻疹和腮腺炎 IgG。排除了没有癌症的患者。
从电子病历中提取患者年龄、性别、自我报告的种族和民族、主要疾病、在样本采集前 30 天内接受的化疗、造血细胞移植 (HCT) 史和最近一次静脉注射免疫球蛋白治疗的日期。
麻疹和腮腺炎 IgG 血清阳性率，定义为抗体检测结果阳性的患者比例，在总体和亚组中进行了测量。
在纳入分析的 959 名患者中，510 名（53%）为男性，样本采集时的平均（SD）年龄为 60（15）岁。大多数患者（576 名[60%]）患有恶性实体肿瘤，383 名（40%）患有血液恶性肿瘤；146 名患者（15%）有 HCT 史。总体而言，麻疹抗体的血清阳性率为 0.75（95%CI，0.72-0.78），腮腺炎抗体的血清阳性率为 0.62（95%CI，0.59-0.65）。血清阳性率最低的是血液恶性肿瘤患者（麻疹为 0.63，腮腺炎为 0.48）、有 HCT 史的患者（麻疹为 0.46，腮腺炎为 0.29）和 30 至 59 岁的患者（麻疹为 0.49-0.63，腮腺炎为 0.41-0.58）。
在这项研究中，25%的门诊癌症患者缺乏麻疹保护性抗体，38%的患者缺乏腮腺炎保护性抗体。保护性抗体的缺乏突出了患者在疫情爆发期间的高风险，强调需要开展以社区为基础的努力，以增加群体免疫来保护这一人群。
