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Thirteen-Valent Pneumococcal Conjugate Vaccine in Children With Acute Lymphoblastic Leukemia: Protective Immunity Can Be Achieved on Completion of Treatment

Bate, J; Borrow, R; Chisholm, J; Clark, S; Dixon, E; Faust, SN; Galanopoulou, A; ... Gray, JC; + view all (2020) 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) pp. 1271-1280. 10.1093/cid/ciz965. Green open access

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Abstract

BACKGROUND Children with acute lymphoblastic leukemia (ALL) are at increased risk of developing 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 >83% of serotypes with data) achieving postvaccination serotype-specific immunoglobulin G ≥0.35 µg/mL and ≥4-fold rise, compared to prevaccination at 1 and 12 months. RESULTS One hundred eighteen children were recruited. Only 12.8% (5/39; 95% confidence interval [CI], 4.3%–27.4%) of patients vaccinated during maintenance (group 1) achieved a protective response at 1 month postvaccination and none had a protective response at 12 months. For group 2 patients, 59.5% (22/37; 95% CI, 42.1%–75.3%) achieved a response at 1 month and 37.9% (11/29; 95% CI, 20.7%–57.7%) maintained immunity at 12 months. For group 3 patients, 56.8% (21/37; 95% CI, 39.5%–72.9%) achieved a protective response at 1 month and 43.3% (13/30; 95% CI, 25.5%–62.6%) maintained immunity at 12 months. CONCLUSIONS This study demonstrated that 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. CLINICAL TRIALS REGISTRATION EudraCT 2009-011587-11.

Type: Article
Title: Thirteen-Valent Pneumococcal Conjugate Vaccine in Children With Acute Lymphoblastic Leukemia: Protective Immunity Can Be Achieved on Completion of Treatment
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/cid/ciz965
Publisher version: https://doi.org/10.1093/cid/ciz965
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Acute Lymphoblastic Leukaemia, Immunisation, Immunocompromised, Pneumococcal Conjugate Vaccine
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10088275
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