The response to vaccination against influenza A(H1N1) 2009, seasonal influenza and Streptococcus pneumoniae in adult outpatients with ongoing treatment for cancer with and without rituximab

Figures & data

Table I. Baseline characteristics of the study population.

Patients characteristics, n = 96
Mean age (age span), years	63 (22–83)
Patients > 64 years, n (%)	53 (55)
Male/female, n (%)	40/56 (41/59)
Curative treatment, n (%)	11 (11)
Adjuvant treatment, n (%)	19 (20)
Palliative treatment, n (%)	66 (69)
Palliative chemotherapy, n (%)
No line	4 (6)
1st line	20 (30)
2nd line	22 (33)
3rd–5th line	20 (30)
Performance status in WHO score, n (%):
0	37 (38)
1	45 (47)
2	11 (11)
3	1 (1)
missing	2 (2)

Table II. Serological response to vaccination against Influenza A(H1N1) measured as HI-titres.

	A/Cal all	A/Cal with ritux	A/Cal no ritux
Prevaccination, at baseline
N (%)	96 (100)	13	83
GMT (range)	6.6 (5–320)	5.3 (5–10)	6.8 (5–320)
SPR (%)	3 (3)	0 (0)	3 (4)
After first dose of vaccine
N (%)	91 (95)	13	78
GMT (range)	41.4 (5–2560)	5.6 (5–10)	57.8 (5–2560)
Factor increase of GMT	6.3	1.1	8.5
SCR (%)	48 (53)	0 (0)	48 (62)
SPR (%)	49 (54)	0 (0)	49 (62)
After second dose of vaccine
N (%)	88 (92)	13	75
GMT (range)	73.3 (5–3620)	6.7 (5–40)	110.9 (5–3620)
Factor increase of GMT	11.1	1.3	16.3
SCR (%)	63 (72)	0 (0)	63 (84)
SPR (%)	66 (75)	1 (8)	65 (87)

A/Cal, A/California/7/2009; GMT, geometric mean titre; N, number of patients; no ritux, patients not treated with rituximab; with ritux, patients treated with rituximab; SCR, seroconversion rate; SPR, seroprotection rate.

Table III. Serological response to vaccination against seasonal influenza A/Brisbane/59/2007(H1N1) and A/Uruguay/10/2007(H3N2) as HI-titres.

	A/Bri all	A/Bri with ritux	A/Bri no ritux	A/Uru all	A/Uru with ritux	A/Uru no ritux
Prevaccination at baseline
N (%)	78 (100)	12 (15)	66 (85)	78 (100)	12 (15)	66 (85)
GMT (range)	12.5 (5–640)	7.9 (5–40)	13.6 (5–640)	10.4 (5–160)	9.4 (5–80)	10.6 (5–160)
SPR (%)	15 (19)	1 (8)	14 (21)	13 (17)	2 (17)	11 (17)
Post-vaccination
N (%)	78 (100)	12 (15)	66 (85)	78 (100)	12 (15)	66 (85)
GMT (range)	41.3 (5–1280)	7.9 (5–40)	55.7 (5–1280)	46.7 (5–7241)	10.3 (5–80)	61.5 (5–7241)
Factor increase of GMT	3.3	1.0	4.1	4.5	1.1	5.8
SCR (%)	28 (37)	0 (0)	28 (42)	33 (42)	0 (0)	33 (50)
SPR (%)	47 (60)	1 (8)	46 (70)	42 (54)	3 (17)	39 (59)

A/Bri, A/Brisbane/59/2007(H1N1); A/Uru, A/Uruguay/10/2007(H3N2); GMT, geometric mean titre; N, number of patients; no ritux, patients not treated with rituximab; SCR, seroconversion rate; SPR, seroprotection rate; with ritux, patients treated with rituximab.

Figure 1. Number of pneumococcal serotypes to which patients showed serotype-specific protective antibodies before and after vaccination, respectively. Horizontal bars represent the mean number of serotypes, symbols represent individual patients (n = 63). The total number of serotype specificities analysed was 14.

Figure 2. Number of patients (total n = 63) developing seroconversion to different numbers of pneumococcal serotypes. Among the 18 non-responder, 8 had received rituximab.