Clinical Efficacy and Timing of Influenza Immunization in Cancer Patients Receiving Chemotherapy

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Patterson, Curtis
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Background: Cancer patients who are immunocompromised due to the nature of their malignancy or treatment with chemotherapy, are at increased of developing complications related to influenza infections. While the influenza vaccination has been shown to be safe in immunocompromised patients, recommendations regarding when to vaccinate patients with cancer are inconsistent, and there are currently no guidelines in place to guide clinical decision-making. This review seeks to assess the efficacy of the influenza vaccine and the proper timing of its administration to immunocompromised adult patients due to cancer. Methodology: A literature search was done of studies that assessed humoral seroconversion after vaccination and clinical effectiveness of the influenza vaccination in immunocompromised cancer patients. The studies included patients with solid tumors, hematological malignancies, and those who were post hematopoietic stem cell transplant. Results: The literature indicates chemotherapy patients generally showed decreased immune response to vaccination, when compared to healthy patients who had not been treated with chemotherapy. However, the aforementioned cancer patients did show adequate seroconversion and patients vaccinated early in their chemotherapy cycle (Day 4-5) as opposed to later (Day 16) had a greater serological response to the influenza vaccinate. Conclusion: The influenza vaccine has been confirmed to produce adequate overall antibody response in 3 chemotherapy patients and to be safe and effective. However, literature indicates it should generally be given early in relation to the chemotherapy cycle to achieve maximum effectiveness. The data supporting this assertion is limited, and the topic requires further study. In view of this, clinicians should consider the potential benefits of influenza immunization for patients being treated with chemotherapy.
influenza immunization, chemotherapy, cancer