Abstract：OBJECTIVE The effictiveness and safety of influenza vaccine for children with acute lymphoblastic leukemia (ALL) were reviewed by searching the published literature to explore the optimal vaccination strategy for clinical reference. METHODS According to the principles of PICOS, the retrieval strategy of the research topic was developed, and the english literature databases such as PubMed and Embase were searched. RESULTS A total of 186 literatures were retrieved, 29 of which were valid.Studies have shown that inactivated influenza vaccination in most children with ALL can produce a moderate intensity immune response, and the seroprotection rates of subtypes/lines can reach 33%-85% (A/HIN1), 38%-92% (A/H3N2), 14%-92%(B) and 37%-88% (pH1N1), respectively. Seroconversion rates were 0%-65% (A/HIN1), 20%-85% (A/H3N2), 0%-92%(B) and 11%-81% (pH1N1), respectively, which were lower than those of healthy children or children with solid tumors.Studies on the effectiveness of vaccines in preventing laboratory-confirmed influenza or influenza-like illness are limited and the RESULTS are conflicting. Higher baseline absolute lymphocyte counts, IgG levels at the time of vaccination, off or low-intensity stages of chemotherapy, older children, and booster doses may result in a stronger immune response.Live attenuated influenza vaccine, high-dose influenza vaccine and adjuvant influenza vaccine did not improve the immune response of children with ALL.The vaccine was well tolerated in all treatment stages with mild adverse reactions. CONCLUSION Available data suggest that the standard dose of inactivated influenza vaccine should be administered at the maintenance chemotherapy stage.The vaccine′s clinical effectiveness has yet to be verified in well-designed clinical trials.
林艳, 杨巨飞, 蔡志波. 儿童急性淋巴细胞白血病患者接种流感疫苗的有效性和安全性系统评价[J]. 中国药学杂志, 2020, 55(2): 153-160.
LIN Yan, YANG Ju-fei, CAI Zhi-bo. Evaluation of Effectiveness and Safety of Influenza Vaccine in Children with Acute Lymphoblastic Leukemia: A Systematic Review. Chinese Pharmaceutical Journal, 2020, 55(2): 153-160.
KERSUN L S, REILLY A F, COFFIN S E, et al. Protecting pediatric oncology patients from influenza. Oncologist, 2013, 18(2):204-211.
TASIAN S K, PARK J R, MARTIN E T, et al. Influenza-associated morbidity in children with cancer. Pediatr Blood Cancer, 2008, 50(5):983-987.
FENG L Z, PENG Z B, WANG D Y, et al. Technical guidelines for seasonal influenza vaccination in China (2018-2019) . Chin J Prev Med(中华预防医学杂志), 2018, 52(11):1101-1114.
GOOSSEN G M, KREMER L C, VAN DE WETERING M D. Influenza vaccination in children being treated with chemotherapy for cancer. Cochrane Database Syst Rev, 2013,(8):CD006484.
PORTER C C, EDWARDS K M, ZHU Y, et al. Immune responses to influenza immunization in children receiving maintenance chemotherapy for acute lymphoblastic leukemia. Pediatr Blood Cancer, 2004, 42(1):36-40.
MCCULLERS J A, HUBER V C. Correlates of vaccine protection from influenza and its complications. Hum Vacc Immunother, 2012, 8(1):34-44.
DOGANIS D, KAFASI A, DANA H, et al. Immune response to influenza vaccination in children with cancer. Hum Vaccin Immunother, 2018, 14(9):2310-2317.
CARR S, ALLISON K J, VAN DE VELDE L A, et al. Safety and immunogenicity of live attenuated and inactivated influenza vaccines in children with cancer. J Infect Dis, 2011, 204(10):1475-1482.
SYKES A, GERHARDT E, TANG L, et al. The effectiveness of trivalent inactivated influenza vaccine in children with acute leukemia. J Pediatr, 2017, 191: 218-224.
CHOI D K, FULEIHAN R L, WALTERHOUSE D O. Serologic response and clinical efficacy of influenza vaccination in children and young adults on chemotherapy for cancer. Pediatr Blood Cancer, 2016, 63(11):2011-2018.
OTTOFFY G, HORVATH P, MUTH L, et al. Immunogenicity of a 2009 pandemic influenza virus A H1N1 vaccine, administered simultaneously with the seasonal influenza vaccine, in children receiving chemotherapy. Pediatr Blood Cancer, 2014, 61(6):1013-1016.
KERSUN L S, REILLY A, COFFIN S E, et al. A prospective study of chemotherapy immunologic effects and predictors of humoral influenza vaccine responses in a pediatric oncology cohort. Influenza Other Resp, 2013, 7(6):1158-1167.
MATSUZAKI A, SUMINOE A, KOGA Y, et al. Immune response after influenza vaccination in children with cancer. Pediatr Blood Cancer, 2005, 45(6):831-837.
KOTECHA R S, WADIA U D, JACOBY P, et al. Immunogenicity and clinical effectiveness of the trivalent inactivated influenza vaccine in immunocompromised children undergoing treatment for cancer. Cancer Med-Us, 2016, 5(2):285-293.
HAKIM H, ALLISON K J, VAN DE VELDE L A, et al. Immunogenicity and safety of high-dose trivalent inactivated influenza vaccine compared to standard-dose vaccine in children and young adults with cancer or HIV infection. Vaccine, 2016, 34(27):3141-3148.
CHISHOLM J C, DEVINE T, CHARLETT A, et al. Response to influenza immunisation during treatment for cancer. Arch Dis Child, 2001, 84(6):496-500.
BATE J, YUNG C F, HOSCHLER K, et al. Immunogenicity of pandemic (H1N1) 2009 vaccine in children with cancer in the United Kingdom. Clin Infect Dis, 2010, 51(12):e95-e104.
LEAHY T R, SMITH O P, BACON C L, et al. Does vaccine dose predict response to the monovalent pandemic H1N1 influenza a vaccine in children with acute lymphoblastic leukemia? A single-centre study. Pediatr Blood Cancer, 2013, 60(10):1656-1661.
CHENG F W T, CHAN P K S, LEUNG W K, et al. Pandemic (H1N1) 2009 vaccine in paediatric oncology patients: one dose or two doses?. Brit J Haematol, 2011, 154(3):408-409.
ANTONIO R, DELOGU G, SALI M, et al. Efficacy of influenza a(H1N1v) vaccination in children with cancer. Pediatr Blood Cancer, 2010, 55(5):973.
BATE J, YUNG C, HOSCHLER K, et al. Immunogenicity of novel influenza a (H1N1) vaccine in UK children with cancer: a single centre study. Pediatr Blood Cancer, 2010, 55(5):823.
MCMANUS M, FRANGOUL H, MCCULLERS J A, et al. Safety of high dose trivalent inactivated influenza vaccine in pediatric patients with acute lymphoblastic leukemia. Pediatr Blood Cancer, 2014, 61(5):815-820.
HALASA N, ENGLUND J A, NACHMAN S, et al. Safety of live attenuated influenza vaccine in mild to moderately immunocompromised children with cancer. Vaccine, 2011, 29(24):4110-4115.
ESPOSITO S, CECINATI V, SCICCHITANO B, et al. Impact of influenza-like illness and effectiveness of influenza vaccination in oncohematological children who have completed cancer therapy. Vaccine, 2010, 28(6):1558-1565.
KERSUN L S, COFFIN S E, LECKERMAN K H, et al. Community acquired influenza requiring hospitalization: vaccine status is unrelated to morbidity in children with cancer. Pediatr Blood Cancer, 2010, 54(1):79-82.
WONG-CHEW R M, FRÍAS M N, GARCÍA-LEÓN M L, et al. Humoral and cellular immune responses to influenza vaccination in children with cancer receiving chemotherapy. Oncol Lett, 2012, 4(2):329-333.
SHAHGHOLI E, EHSANI M A, SALAMATI P, et al. Immunogenicity of trivalent influenza vaccine in children with acute lymphoblastic leukemia during maintenance therapy. Pediatr Blood Cancer, 2010, 54(5):716-720.
KIM D H, SONG B S, LEE J A, et al. Assessment of influenza vaccine immunogenicity in immunocompromized host during 2009 influenza season: a single institution experience. Korean Journal of Pediatric Infectious Diseases, 2012, 19(1):1.
REILLY A, KERSUN L S, MCDONALD K, et al. The efficacy of influenza vaccination in a pediatric oncology population. J Pediatr Hematol/Oncol, 2010, 32(5):e177-e181.
HSIEH Y C, LU M Y, KAO C L, et al. Response to influenza vaccine in children with leukemia undergoing chemotherapy. J Formos Med Assoc, 2002, 101(10):700-704.
BRYDAK L B, ROKICKA-MILEWSKA R, MACHALA M, et al. Immunogenicity of subunit trivalent influenza vaccine in children with acute lymphoblastic leukemia. Pediatr Infect Dis J, 1998, 17(2):125-129.
HAKIM H, ALLISON K J, VAN DE VELDE L A, et al. Immunogenicity and safety of inactivated monovalent 2009 H1N1 influenza A vaccine in immunocompromised children and young adults. Vaccine, 2012, 30(5):879-885.
YEN T Y, JOU S T, YANG Y L, et al. Immune response to 2009 pandemic H1N1 influenza virus A monovalent vaccine in children with cancer. Pediatr Blood Cancer, 2011, 57(7):1154-1158.
MIKULSKA M, CESARO S, DE LAVALLADE H, et al. Vaccination of patients with haematological malignancies who did not have transplantations: guidelines from the 2017 European Conference on Infections in Leukaemia (ECIL 7). Lancet Infect Dis, 2019, 19(6):e188-e199.
RUBIN L G, LEVIN M J, LJUNGMAN P, et al. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis, 2014, 58(3):309-318.
MARTIRE B, AZZARI C, BADOLATO R, et al. Vaccination in immunocompromised host: recommendations of Italian Primary Immunodeficiency Network Centers (IPINET). Vaccine, 2018, 36(24):3541-3554.
CRAWFORD N. Immunizations in children with cancer. Paediatrics and Child Health, 2012, 22(3):121-122.
VESIKARI T, KARVONEN A, KORHONEN T, et al. A randomized, double-blind study of the safety, transmissibility and phenotypic and genotypic stability of cold-adapted influenza virus vaccine. Pediatr Infect Dis J, 2006, 25(7):590-595.
YANG J, ATKINS K E, FENG L, et al. Seasonal influenza vaccination in China: landscape of diverse regional reimbursement policy, and budget impact analysis. Vaccine, 2016, 34(47):5724-5735.