1840P - Reduced antibody levels and high seronegativity rates against vaccine preventable diseases pose a risk factor for infections in patients with solid and hematologic cancers

Abstract

BackgroundNew therapeutic concepts have led to substantial improvement in the survival of cancer patients. Yet, due to their compromised immune system these patients are at increased risk to encounter infections and need particular care with regard to vaccine preventable diseases (VPDs). Decreased seroprevalence to VPDs has already been reported in children suffering from malignancies, yet data from adult cancer patients are scarce. Here, we examined the antibody (Ab) titers as well as seronegativity levels against common VPDs in adults with cancer and compared them to healthy controls. MethodsAbs mounted against measles, mumps, rubella, varicella, hepatitis A and B, diphtheria, tetanus, pertussis and tick-borne encephalitis (TBE) were evaluated in sera from 478 cancer patients and 117 age- and gender-matched controls by standard ELISAs. ResultsCompared to controls, significantly lower Ab levels against 5 out of the 10 investigated VPDs (p<0.05), i.e. measles, hepatitis B, diphtheria, tetanus and TBE, were found in patients with solid cancers (SC), while patients with haematological cancers (HC) had significantly lower antibody titers against all 10 examined VPDs (p<0.05). In accordance, compared to controls, cancer patients had increased seronegativity rates against VPDs, of which those against diphtheria (41% in SC patients and 76% in HC patients), hepatitis B (74% in SC patients and 87% in HC patients) and pertussis (75% in SC patients and 91% in HC patients) were the highest. ConclusionsPatients with SC and HC have lower antibody titers and higher seronegativity rates against the most common VPDs compared to the general population. Thus, in order to prevent severe infections in this patient group, the vaccination status as well as vaccination programs need to be routinely implemented into oncological treatment concepts. Legal entity responsible for the studyUrsula Wiedermann. FundingInstitute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna. DisclosureA.S. Berghoff: Honoraria (self), Advisory / Consultancy, Research grant / Funding (self): Daiichi Sankyo; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self), Travel / Accommodation / Expenses: Roche; Honoraria (self), Advisory / Consultancy: Bristol-Meyers Squibb; Honoraria (self), Advisory / Consultancy: Merck; Travel / Accommodation / Expenses: Amgen; Travel / Accommodation / Expenses: AbbVie. C.C. Zielinski: Honoraria (self), Advisory / Consultancy, Member of scientific advisory board until September 2018: Imugene; Honoraria (self), Advisory / Consultancy: Roche; Honoraria (self), Advisory / Consultancy: Novartis; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution), institution: Central European Cooperative Oncology Oncology Group (CECOG): BMS; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution), institution: Central European Cooperative Oncology Oncology Group (CECOG): MSD; Honoraria (self), Advisory / Consultancy: Ariad; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution), institution: Central European Cooperative Oncology Oncology Group (CECOG): Pfizer; Honoraria (self), Advisory / Consultancy: Merrimack; Honoraria (self), Advisory / Consultancy: Merck KGaA; Honoraria (self), Advisory / Consultancy: Fibrogen; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution), institution: Central European Cooperative Oncology Oncology Group (CECOG): AstraZeneca; Honoraria (self), Advisory / Consultancy: Tesaro; Honoraria (self), Advisory / Consultancy: Gilead; Honoraria (self), Advisory / Consultancy: Servier; Honoraria (self), Advisory / Consultancy: Shire; Honoraria (self), Advisory / Consultancy: Eli Lilly; Honoraria (self), Advisory / Consultancy: Athenex. U. Wiedermann: Research grant / Funding (institution), Officer / Board of Directors, CSO until October 2018: Imugene; Research grant / Funding (institution): Pfizer; Research grant / Funding (institution): GSK; Research grant / Funding (institution): Themis. All other authors have declared no conflicts of interest.