Article
Response to influenza immunisation during treatment for cancer
J C Chisholma, T Devinea, A Charlettb, C R Pinkertona, M Zambonc
a Children's
Unit, Royal Marsden Hospital, Down's Rd, Sutton, Surrey SM2 5PT,
UK, b PHLS Statistics Unit, Central Public Health
Laboratory, 61 Colindale Ave, Colindale, London NW9 5HT, UK, c Enteric, Respiratory, and
Neurological Virus Laboratory, Central Public Health Laboratory
Correspondence to: Dr J C Chisholm, Dept Paediatric Oncology, Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK julia.chisholm{at}gosh-tr.nthames.nhs.uk
Accepted 8 January
2001
AIMS
To assess the annual risk of
influenza infection in children with cancer and the immunogenicity of a
trivalent split virus influenza vaccine in these children.
METHODSEighty four children with
cancer were tested for susceptibility to the circulating strains of
influenza virus in autumn 1995 and 1996. Non-immunised children were
reassessed the following spring for serological evidence of natural
infection. Forty two patients received two doses of influenza vaccine.
These children were receiving continuing chemotherapy for acute
lymphoblastic leukaemia or were within six months of completing chemotherapy.
RESULTSAmong the 84 children
tested for influenza virus susceptibility only 8% of patients were
fully protected (antibody titres 
40) against all three of the
prevalent influenza virus strains; 33% were susceptible to all three
viruses. Evidence of acquired natural infection was seen in 30% of
unimmunised patients. Among immunised susceptible patients, 66% made
some protective response to the vaccine and 55% showed protective
antibody titres to all three viral strains following vaccination. Older
age was associated with increased response to the H1N1 and H3N2 vaccine
components, but total white cell count or neutrophil count at
immunisation, type of cancer, or length of time on treatment for acute
lymphoblastic leukaemia did not affect response.
CONCLUSIONSMost children with
cancer studied were at risk of influenza infection. A significant
response to immunisation was seen, supporting annual influenza
vaccination for children being treated for cancer.
Keywords: influenza; immunisation; susceptibility; cancer
© 2001 by Archives of Disease in Childhood
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