Infectious Disease

Many cancer patients lack adequate immunity to measles, mumps

23 August 2021

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Pergam reports grants from Global Life Technologies and vaccines for NIH-backed clinical trials from Chimerix, Merck, and Sanofi outside of the work submitted. Krantz does not disclose any relevant financial information. Please refer to the study for all relevant financial information from the other authors.

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According to a study conducted by researchers at the Fred Hutchinson Cancer Research Center and published on the JAMA Network Open, many people with cancer lack adequate immune defenses against the measles and mumps viruses.

The results showed that young adults and bone marrow transplant recipients are particularly at risk.

Many people with cancer lack an adequate immune defense against the measles and mumps viruses.

Data from Marquis SR, et al. JAMA network open. 2021; doi: 10.1001 / jamanetworkopen.2021.18508.

“Our results really underscore the need to increase immunity at the community level, particularly among health care workers or caregivers who have frequent contact with [patients with cancer]to protect this vulnerable population “, Elisabeth M. Krantz, MRS, Biostatisticians at Fred Hutch and co-senior study’s author said in a press release.

In the cross-sectional study, Krantz and colleagues evaluated remaining clinical plasma samples acquired from consecutive cancer patients at the Seattle Cancer Care Alliance / Fred Hutchinson Research Center in August 2019. They used a commercial enzyme-linked immunosorbent assay to test the samples for measles and mumps immunoglobulin G (IgG). They also extracted the following patient data from electronic medical records: age, gender, self-reported race / ethnicity, underlying disease, treatment with chemotherapy within the last 30 days prior to specimen collection, history of hematopoietic stem cell transplant, and date of last IV IgG treatment.

The analysis included 959 patients (mean age at sample collection 60 years; 53% men; 81% white), of whom 60% had a malignant solid tumor and 40% a haematological malignancy. Fifteen percent of patients (n = 146) had a history of HSCT.

Researchers measured measles and mumps IgG seroprevalence, defined as the percentage of patients with positive antibody test results, in the general population and in the demographic and clinical subgroups.

The results showed an overall seroprevalence of 0.75 (95% CI, 0.72-0.78) for measles antibodies and 0.62 (95% CI, 0.59-0.65) for mumps antibodies. Patients with haematological malignancies had the lowest seroprevalence of measles (0.63) and mumps (0.48) antibodies. Other low seroprevalence groups included those with a history of HSCT (0.46 for measles and 0.29 for mumps) and those aged 30 to 59 years (0.49-0.63 for measles and 0.41-0 , 58 for mumps).

Researchers expressed concern that the COVID-19 pandemic has slowed vaccination progress in children, which has limited measles and mumps outbreaks. In recent years, vaccination rates among children against measles, mumps and rubella have declined in parts of the United States, they noted.

“People no longer go to doctor’s appointments and we no longer send people to the fields to vaccinate children. I am concerned that measles outbreaks will occur around the world because we haven’t addressed this or invested resources. ” Steven A. Percham, MD, MPH, Infectious disease specialist at Fred Hutch, medical director of infection prevention at the Seattle Cancer Care Alliance and co-senior author on the study, said in the press release. “Mumps and measles outbreaks may be something that will be in our future if we don’t catch up on vaccines.”

Reviewing their results, the researchers hypothesized that the low immunity to measles and mumps in young people in the study could be due to cancers, including haematological malignancies, that are prevalent in those age groups.

“Because solid tumor cancers are more common in the elderly, the younger patients in the study were more likely to have hematologic malignancies,” said Krantz. “Careful analysis of the data suggested that both age and type of cancer are likely factors in measles and mumps immunity.”

References:

Fred Hutch. According to the study, one in four cancer patients lacks adequate immunity to measles and mumps. Available at: www.fredhutch.org/en/news/releases/2021/07/One-in-four-cancer-patients-lack-sufficient-immunity-against-masles-and-mumps-study-finds.html. Accessed August 5, 2021.
Marquis SR et al. JAMA network open. 2021; doi: 10.1001 / jamanetworkopen.2021.18508.

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