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IMMUNITY AGAINST POLIO, DIPHTERIA AND TETANUS AFTER CHEMOTHERAPY FOR AML AND HIGH-GRADE LYMPHOMA

IMMUNITY AGAINST POLIO, DIPHTERIA AND TETANUS AFTER CHEMOTHERAPY FOR AML AND HIGH-GRADE LYMPHOMA S Einarsdottir 1 , P Horal 2 , P-O Andersson 1 , B Kaijser 3 , V Karlsson 4 , M Brune 1

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IMMUNITY AGAINST POLIO, DIPHTERIA AND TETANUS AFTER CHEMOTHERAPY FOR AML AND HIGH-GRADE LYMPHOMA

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  1. IMMUNITY AGAINST POLIO, DIPHTERIA AND TETANUS AFTER CHEMOTHERAPY FOR AML AND HIGH-GRADE LYMPHOMA S Einarsdottir1, P Horal2, P-O Andersson1, B Kaijser3, V Karlsson4, M Brune1 1Section of Hematology and Coagulation, 2Departments of Clinical Virology and 3Clinical Bacteriology, 4Uddevalla County Hospital Göteborg University, S W E D E N BACKGROUND • Subprotective antibody levels against diphteria and tetanus were found in a pediatric pts after ALL treatment (Ek T et al 2005) • Information is scarce regarding antibody levels in adults after conventional chemotherapy for hematological malignancies. AIMS To investigate if antibody levels against diphtheria, tetanus and polio are retained in adults after intense chemotherapy treatment of AML and high-grade non-Hodgkin´s lymphoma (HGNHL) PATIENTS and CONTROLS HGNHL: Patients: N=29 (14 males, 15 females), age 65 (20-80) yrs, in CR1 for a duration of 21 (6-48) months Controls: N=26, sex- and age-matched healthy persons AML: Patients: N=16 (9 males, 7 females), age 59 (20-72) yrs, in CR1 for a duration of 36 (6-84) mo Controls: N=14, sex- and age-matched healthy persons CONCLUSION • We report a high prevalence of subprotective antibody levels against polio and diphtheria in AML and lymphoma patients in CR after conventional therapy not encompassing stem cell transplantation • We suggest that assessment of immunity status (and perhaps re-immunization) may be considered not only in transplantated patients but also after intensive conventional chemotherapy for leukemia and lympoma METHODS • Polio: Immunity against polio types 1, 2 and 3 were separately assessed utilizing a neutralization assay • Tetanus and diphteria: Immunity against tetanus and diphtheria toxoids were determined using an ELISA and a neutralization test, respectively. • Immune or susceptible? Protective thresholds as defined for clinical samples by the microbiology lab were used to categorize patients and controls as immune or not immune (susceptible) to infection

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