The humoral immune response to high-dose influenza vaccine in persons with monoclonal B-cell lymphocytosis (MBL) and chronic lymphocytic leukemia (CLL)

• Published in: Vaccine Vol. 39; no. 7; pp. 1122 - 1130
• Main Authors: Whitaker, Jennifer A., Parikh, Sameer A., Shanafelt, Tait D., Kay, Neil E., Kennedy, Richard B., Grill, Diane E., Goergen, Krista M., Call, Timothy G., Kendarian, Saad S., Ding, Wei, Poland, Gregory A.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 12.02.2021; Elsevier Limited
• Subjects: absorbents; Adult; Age; Aged; Allergy and Immunology; Antibodies; Antibodies, Viral; B-cell; B-Lymphocytes; blood serum; Blood tests; Chemotherapy; Chronic; Chronic lymphocytic leukemia; Drug dosages; Flow cytometry; hemagglutination; Hemagglutination inhibition; Hemagglutination Inhibition Tests; Humans; humoral immunity; Immune response; Immune response (humoral); Immune system; Immunity, Humoral; Immunogenicity; Immunoglobulins; Immunological memory; Infections; Influenza; Influenza A Virus, H1N1 Subtype; Influenza A Virus, H3N2 Subtype; Influenza B; Influenza Vaccines; Influenza, Human - prevention & control; Leukemia; Leukemia, Lymphocytic, Chronic, B-Cell; Lymphatic leukemia; Lymphocytes B; Lymphocytic; lymphocytic leukemia; Lymphocytosis; Medical laboratories; Memory cells; Monoclonal B cell lymphocytosis; Pilot Projects; Population; Prospective Studies; Seasons; Seroconversion; Vaccination; Vaccines; viruses; California; Northern Hemisphere; United States > US; Massachusetts; Influenza vaccines; Lymphocytic; Chronic; B-cell; Influenza; Leukemia; Monoclonal B cell lymphocytosis
• ISSN: 0264-410X; 1873-2518; 1873-2518
• DOI: 10.1016/j.vaccine.2021.01.001

•First published vaccine responses in those with monoclonal B cell lymphocytosis (MBL).•High-dose influenza vaccine responses in MBL and chronic lymphocytic leukemia (CLL).•Seroprotection: 63% (A/H1N1); 91% (A/H3N2); and 43% (B) for cohort (MBL and CLL).•Higher seroprotection rates for influenza B seen were in those with MBL than CLL. Limited data are available regarding the immunogenicity of high-dose influenza vaccine among persons with chronic lymphocytic leukemia (CLL) and monoclonal B cell lymphocytosis (MBL). A prospective pilot study of humoral immune responses to 2013–2014 and 2014–2015 high-dose trivalent influenza vaccine (HD IIV; Fluzone® High-Dose; Sanofi Pasteur) was conducted among individuals with MBL and previously untreated CLL. Serum hemagglutination inhibition (HAI) antibody titers were measured at baseline and Day 28 after vaccination; seroprotection and seroconversion rates were determined. Memory B cell responses were assessed by B-cell enzyme-linked immune absorbent spotassays. Thirty subjects (17 CLL and 13 MBL) were included. Median age was 69.5 years. Day 28 seroprotection rates for the cohort were 19/30 (63.3%) for A/H1N1; 21/23 (91.3%) for A/H3N2; and 13/30 (43.3%) for influenza B. Those with MBL achieved higher day 28 HAI geometric mean titers (54.1 [4.9, 600.1] vs. 12.1 [1.3, 110.1]; p = 0.01) and higher Day 28 seroprotection rates (76.9% vs. 17.6%; p = 0.002) against the influenza B-vaccine strain virus than those with CLL. Immunogenicity of the HD IIV3 in patients with CLL and MBL is lower than reported in healthy adults. Immunogenicity to influenza B was greater in those with MBL than CLL.