Ovarian Cancer Canada

Western Regional Blog – BC, YK, AB, NWT and Nunavut

Immunologic consequences of chemotherapy for ovarian cancer

Patients undergoing treatment for ovarian cancer are profoundly immunosuppressed and unable to mount an adequate immune response to seasonal influenza vaccine.

The B cell compartment was significantly functionally compromised. Monoclonal B cell lymphocytosis was seen. Immunologic consequences of chemotherapy for ovarian cancer: Impaired responses to the influenza vaccine

Objectives

To examine the effect of chemotherapy for ovarian cancer on immunologic function and to define the effect on the serologic response to the influenza vaccine.

Methods

Under IRB approved protocols, patients with ovarian cancer were administered seasonal trivalent killed influenza vaccines. Peripheral blood was collected for immunologic assessments. Serum was analyzed for hemagglutination inhibition (HAI) antibody titers. Peripheral blood mononuclear cells were isolated to characterize T and B cell populations and function.

Results

Thirty-one patients were recruited: 13 in remission receiving a dendritic cell vaccine with or without a single dose of low-dose cyclophosphamide, 3 in remission not receiving treatment, and 15 undergoing standard therapy. Significant effects on T cell and B cell subset distributions were seen. Functional effects were also seen. Few patients were able to mount a 4-fold HAI antibody response. A 4-fold response was observed for H1N1 in 20%, for H3N2 in 26%, and for influenza B in 6%. Pre-existing exposure to influenza was predictive of responders.

Conclusions

Despite CDC recommendations that patients undergoing chemotherapy receive influenza vaccine, there is little evidence to support its serologic effectiveness in this population. Patients with ovarian cancer are almost uniformly unable to mount a meaningful antibody response. These findings have serious implications for future resource allocation for both seasonal and novel pandemic influenza outbreak and understanding the immunologic deficits as a result of chemotherapy may improve patient care.

http://www.sciencedirect.com/science/article/pii/S0264410X13012152

Christina S. Chu, Jean D. Boyer, Abbas Jawad, Kenyetta Mcdonald, Wade T. Rogers, Eline T. Luning Prak, Kathleen E. Sullivan

Complementary and Alternative Therapies

CAMEO

Research in BC

The Injustices of Ovarian Cancer

Ovarian Cancer Canada

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