Only a small % (10%) of immunosuppressed patients with malignant lymphoma responded using a 4-fold upsurge in their antibody titer towards the major antigens from the 2003 influenza vaccine. both influenza A and B antigens and 3 of 29 taken care of immediately the influenza B antigen. In the control group 13 of 29 (45%) taken care of immediately an influenza A antigen and 14 of 29 (48%) got a 4-flip response towards the B antigen. Seven of 29 handles (24%) had a 4-fold increase in their titers to both the A and B antigens. This study confirmed the low incidence of response or efficacy to the influenza vaccine reported in previous studies. Only a small percentage (10%) of immunosuppressed patients with malignant lymphoma responded with a 4-fold increase in their antibody titer to the major antigens of the 2003 influenza vaccine. Most interestingly, less than 50% of the aged-matched control population studied responded with a 4-fold increase in their antibody titer. Additional studies are needed to determine methods for improving the efficacy of the vaccine and the effectiveness of the influenza vaccination program in preventing influenza infections in the United States. Keywords: Antigens, Influenza, Lymphoma, Titer, Vaccine Influenza is an important cause of morbidity and mortality worldwide. The elderly and those with underlying medical illnesses appear to be particularly vulnerable populations for influenza infection. Vaccination for individuals who are at increased risk for influenza infection and influenza-associated pneumonia has been recommended by the Centers for Disease Control and Prevention.1 This would include the elderly, individuals who have chronic disease or a malignancy, and those who are currently receiving immunosuppressive medications (e.g., corticosteroids, chemotherapy).2,3 The efficacy of this immunization program is often difficult to quantify since most studies in the current literature use surrogate endpoints and the parameters used to determine the response to vaccines vary from study to study. Pre- and post-immunization serum antibody titers are commonly used to measure the immunological response, with a 4-fold increase in antibody Fosphenytoin disodium titer Fosphenytoin disodium accepted as being indicative of vaccine efficacy. However, given the list of recommended immunizations for adults, it is unlikely that titers to determine the efficacy of each vaccine are measured and recorded subsequent to administration. Nowhere GDF5 is this issue Fosphenytoin disodium more clouded and confusing than the annual emphasis and media attention placed on the need to immunize virtually everyone in the United States against influenza infection. Every year, millions of Americans are urged to receive the flu vaccine during the fall months of the year to provide them with protection from the flu or, more specifically, influenza virus infections. Yet little data exist to determine the effectiveness of this immunization. There are few studies in the current literature that provide credible data on the incidence of influenza infection each year in the United States. The data that are available are often inaccurate and unreliable, mainly due to the loose definition and interpretation of an influenza infection. Infections are usually recorded under the rubric of the flu or flu-like illness without documentation of an influenza viral infection. Most large studies on this subject use a variety of nonspecific systemic and subjective symptoms, e.g., fever, general malaise, headache, musculoskeletal aches and pains and pneumonia (flu-like illness), that are interpreted as representing the flu or influenza infection. These symptoms are frequently experienced in association with a host of other viral infections. 4C16 Few of these studies document actual influenza viral infection by using direct fluorescence antibody testing, polymerase chain reaction (PCR) analysis and cell culture techniques to isolate and identify the virus. The issue of providing protection to immunocompromised individuals with vaccines further compounds the problem of vaccine efficacy and Fosphenytoin disodium effectiveness. Numerous studies have shown the inability of the immunocompromised host and individuals with malignant diseases to mount an adequate immunologic response to a variety of vaccines. In particular, lymphoreticular malignancies are inherently immunosuppressive and the patients immune system is often further compromised by advanced age and aggressive chemotherapy regimens.17C23 In this study we enrolled 29 patients with a diagnosis of malignant lymphoma (Hodgkins disease and non-Hodgkins lymphoma) who were being treated.
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