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Thirteen-valent pneumococcal conjugate vaccine in children with acute lymphoblastic leukemia: Protective immunity can be achieved on completion of treatment

Thirteen-valent pneumococcal conjugate vaccine in children with acute lymphoblastic leukemia: Protective immunity can be achieved on completion of treatment
Thirteen-valent pneumococcal conjugate vaccine in children with acute lymphoblastic leukemia: Protective immunity can be achieved on completion of treatment
Background
Children with acute lymphoblastic leukaemia (ALL) are at increased risk of invasive pneumococcal disease. This study describes the immunogenicity of 13-valent pneumococcal conjugate vaccine (PCV13) during and after chemotherapy.

Methods
Children with ALL were allocated to study groups and received a single dose of PCV13: Group 1 - maintenance chemotherapy; Group 2 - end of chemotherapy; Group 3 - 6 months after chemotherapy. A protective vaccine response was defined as at least 10 of 12 serotypes (or greater than 83% of serotypes with data) achieving post-vaccination serotype-specific IgG ≥ 0.35 µg/mL and ≥ 4 fold rise, compared to pre-vaccination at 1 and 12 months.

Results
One hundred and eighteen children were recruited. Only 12.8% (5/39; 95% CI 4.3% to 27.4%) of patients vaccinated during maintenance (Group 1) achieved a protective response at 1 month post-vaccination and none had a protective response at 12 months. For Group 2 patients, 59.5% (22/37; 95% CI 42.1% to 75.3%) achieved a response at 1 month and 37.9% (11/29; 95% CI 20.7% to 57.7%) maintained immunity at 12 months. For Group 3 patients, 56.8% (21/37; 95% CI 39.5% to 72.9%) achieved a protective response at 1 month and 43.3% (13/30; 95% CI 25.5% to 62.6%) maintained immunity at 12 months.

Conclusion
This study demonstrated the earliest time point at which protective immunity can be achieved in children with ALL is on completion of chemotherapy. This is earlier than current recommendations and may improve protection during a period when children are most susceptible to infection.
acute lymphoblastic leukaemia, pneumococcal conjugate vaccine, immunization, immunocompromised
1058-4838
1271-1280
Bate, Jessica
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Borrow, Ray
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Chisholm, Julia C.
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Clarke, Stuart
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Dixon, Elizabeth
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Faust, Saul
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Galanopoulou, Angeliki
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Goldblatt, David
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Heath, Paul T.
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Maishman, Thomas
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Mapstone, Susan
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Patel, Soonie R.
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Williams, Antony P.
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Gray, Juliet
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Bate, Jessica
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Borrow, Ray
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Chisholm, Julia C.
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Clarke, Stuart
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Dixon, Elizabeth
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Faust, Saul
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Galanopoulou, Angeliki
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Goldblatt, David
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Heath, Paul T.
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Maishman, Thomas
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Mapstone, Susan
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Patel, Soonie R.
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Williams, Antony P.
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Gray, Juliet
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Bate, Jessica, Borrow, Ray, Chisholm, Julia C., Clarke, Stuart, Dixon, Elizabeth, Faust, Saul, Galanopoulou, Angeliki, Goldblatt, David, Heath, Paul T., Maishman, Thomas, Mapstone, Susan, Patel, Soonie R., Williams, Antony P. and Gray, Juliet (2019) Thirteen-valent pneumococcal conjugate vaccine in children with acute lymphoblastic leukemia: Protective immunity can be achieved on completion of treatment. Clinical Infectious Diseases, 71 (5), 1271-1280. (doi:10.1093/cid/ciz965).

Record type: Article

Abstract

Background
Children with acute lymphoblastic leukaemia (ALL) are at increased risk of invasive pneumococcal disease. This study describes the immunogenicity of 13-valent pneumococcal conjugate vaccine (PCV13) during and after chemotherapy.

Methods
Children with ALL were allocated to study groups and received a single dose of PCV13: Group 1 - maintenance chemotherapy; Group 2 - end of chemotherapy; Group 3 - 6 months after chemotherapy. A protective vaccine response was defined as at least 10 of 12 serotypes (or greater than 83% of serotypes with data) achieving post-vaccination serotype-specific IgG ≥ 0.35 µg/mL and ≥ 4 fold rise, compared to pre-vaccination at 1 and 12 months.

Results
One hundred and eighteen children were recruited. Only 12.8% (5/39; 95% CI 4.3% to 27.4%) of patients vaccinated during maintenance (Group 1) achieved a protective response at 1 month post-vaccination and none had a protective response at 12 months. For Group 2 patients, 59.5% (22/37; 95% CI 42.1% to 75.3%) achieved a response at 1 month and 37.9% (11/29; 95% CI 20.7% to 57.7%) maintained immunity at 12 months. For Group 3 patients, 56.8% (21/37; 95% CI 39.5% to 72.9%) achieved a protective response at 1 month and 43.3% (13/30; 95% CI 25.5% to 62.6%) maintained immunity at 12 months.

Conclusion
This study demonstrated the earliest time point at which protective immunity can be achieved in children with ALL is on completion of chemotherapy. This is earlier than current recommendations and may improve protection during a period when children are most susceptible to infection.

Text
ciz965 - Accepted Manuscript
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Thirteen-Valent Pneumococcal Conjugate Vaccine in Children With Acute Lymphoblastic Leukemia: Protective Immunity Can Be Achieved on Completion of Treatment - Version of Record
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Accepted/In Press date: 2 October 2019
e-pub ahead of print date: 5 October 2019
Keywords: acute lymphoblastic leukaemia, pneumococcal conjugate vaccine, immunization, immunocompromised

Identifiers

Local EPrints ID: 434825
URI: http://eprints.soton.ac.uk/id/eprint/434825
ISSN: 1058-4838
PURE UUID: f9627d9d-c64f-4bb7-869f-11802d1f2d8c
ORCID for Stuart Clarke: ORCID iD orcid.org/0000-0002-7009-1548
ORCID for Saul Faust: ORCID iD orcid.org/0000-0003-3410-7642
ORCID for Juliet Gray: ORCID iD orcid.org/0000-0002-5652-4722

Catalogue record

Date deposited: 11 Oct 2019 16:30
Last modified: 26 Nov 2021 06:53

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Contributors

Author: Jessica Bate
Author: Ray Borrow
Author: Julia C. Chisholm
Author: Stuart Clarke ORCID iD
Author: Elizabeth Dixon
Author: Saul Faust ORCID iD
Author: Angeliki Galanopoulou
Author: David Goldblatt
Author: Paul T. Heath
Author: Thomas Maishman
Author: Susan Mapstone
Author: Soonie R. Patel
Author: Juliet Gray ORCID iD

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