Evaluation of Humoral Response to Trivalent Influenza Vaccination in Patients with Non-Hodgkin Lymphoma Previously Treated or Untreated with Chemotherapy.

The aim of this study was to assess humoral response to influenza vaccination in 47 patients with non-Hodgkin lymphoma (NHL) in comparison with 45 healthy individuals (age 12–76 years, median 41 years; 13 males and 32 females). Patients (age 36–82, median 60 years; 24 males and 23 females) consisted of two groups, previously treated with chemotherapy (group A, n=32) or untreated (group B, n=15). In autumn 2003, all subjects were vaccinated with influenza vaccine ([Isquo]influvac’, Solvay Pharmaceuticals B.V.). Antibody responses to influenza hemagglutinin and neuraminidase were determined in sera collected before and 1 month after vaccination by hemagglutination and neuraminidase inhibition tests. Statistical analysis was performed using the Mann-Whitney unpaired and Wilcoxon paired tests. After vaccination geometric mean antibody titers (GMTs) of antihemagglutinin (HI) antibodies significantly increased (p<0.05) and mean fold increases (MFIs) from 10.3 to 26.7 in group A, 5.9 to 48.9 in group B and from 9.1 to 24.4 in the controls. Pre-vaccination protection rate, i.e. the number of subjects with the protective HI antibody titers >1:40, ranged from 0% to 9.4% in group A, 0% to 13.3% in group B and from 2.2% to 20% in the controls. After vaccination protection rates increased and ranged from 78.1% to 87.5%, 73.3% to 93.3% and 66.7% to 82.2%, respectively. Response rates, i.e. the number of subjects with at least 4-fold increase of HI antibody titers after vaccination, ranged from 59.4% to 84.4%, 73.3% to 86.7% and from 51.1% to 66.7%, respectively. In both study groups and in the controls, post-vaccination antineuraminidase (NI) antibody titers were higher (p<0.05) than pre-vaccination titers. MFIs of NI antibody levels ranged from 9.8 to 17.3 in group A, 6.5 to 10.9 in group B and 4.8 to 10.3 in the controls. After vaccination, only hemagglutinin H1 antibody titers were (p<0.05) higher in the controls than in the study group A and B. In the other cases, there were no statistically significant differences between groups or there were higher values in patients with NHL than in the control group. The results of this study indicate that influenza vaccine is immunogenic in patients with NHL and stimulates production of HI and NI antibodies in the titers comparable to healthy subjects.