Anti-infective vaccination strategies in patients with hematologic malignancies or solid tumors—Guideline of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO)

Rieger, Christina; Liss, Blasius; Mellinghoff, Sibylle C.; Buchheidt, Dieter; Cornely, Oliver A.; Egerer, Gerlinde; Heinz, Werner; Hentrich, Marcus; Maschmeyer, Georg; Mayer, Karin; Sandherr, Michael; Silling, Gerda; Ullmann, Andrew J.; Vehreschild, Maria J.G.T.; Lilienfeld‐Toal, Marie von; Hh, Wolf; Lehners, Nicola

doi:10.1093/annonc/mdy117

Cited by 73 publications

(91 citation statements)

References 130 publications

(170 reference statements)

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“…Most centers start to vaccinate children with inactivated vaccines 3 months after autologous HSCT, which is also recommended by current guidelines [10,17,18] (▶ Table 2). In contrast, we found a wide variation regarding the administration of live-attenuated vaccines.…”

Section: Discussionmentioning

confidence: 99%

Revaccination in Children Undergoing Autologous Hematopoietic Stem Cell Transplantation: Results of a Survey in Germany, Austria and Switzerland

Laws

Simon²,

Lehrnbecher

2019

Klin Padiatr

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Background Due to the potential loss of protective antibody titers after autologous hematopoietic stem cell transplantation (HSCT), revaccination is important. The aim of the study was to evaluate the current strategies in Germany, Austria and Switzerland for revaccination of children after autologous HSCT. Methods An internet-based survey was performed, and results were analyzed in a descriptive way. Results Twenty-seven out of 31 centers (87%) centers responded, and all centers administer revaccination. More than 90% of the centers re-vaccinate against tetanus, diphtheria, hepatitis B, H. influenzae B, poliomyelitis, measles, mumps, and rubella, whereas considerable less centers vaccinate against encapsulated bacteria, in particular against meningococci. First revaccination with non-live vaccine is performed by almost all centers between 3 and 9 months. Timing of live-attenuated vaccines varied widely [6 months (4 centers), 9 months (1), 12 months (11) and 24 months (4)]. Similarly, there is a wide variation in the delay of live-vaccines after immunoglobulin administration (2 weeks to 9 months), and in the testing of immunological parameters prior to vaccination. Conclusion Our survey demonstrates a wide variation regarding the timing of live-attenuated vaccines after autologous HSCT or after immunoglobulin administration and regarding immunization against encapsulated bacteria. Many centers do not adhere to current recommendations. Studies should focus on a detailed analysis of the epidemiology of infections with encapsulated bacteria after pediatric autologous HSCT as well as on the immune recovery and the response to revaccination in this setting.

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Section: Discussionmentioning

confidence: 99%

Revaccination in Children Undergoing Autologous Hematopoietic Stem Cell Transplantation: Results of a Survey in Germany, Austria and Switzerland

Laws

Simon²,

Lehrnbecher

2019

Klin Padiatr

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“…The 13-valent conjugate vaccine, however, comprises only about 30% of pneumococcal infections in adults, in contrast the 23-valent polysaccharide inoculum about 60-70%. Therefore, the sequential vaccination with both inocula conveys the best protection against pneumococcal infections at the moment [3][4][5][6][7][8].…”

Section: Individuals With Immune-suppression Advanced Liver Cirrhosimentioning

confidence: 99%

Update on the “Choosing Wisely” initiative in infectious diseases in Germany

Draenert

Jung

2020

Infection

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Purpose The Choosing Wisely ® initiative is an international campaign addressing over-and underuse of diagnostic and therapeutic measures in infectious diseases among others. Since 2016, the German Society for Infectious Diseases (DGI) has constantly designed new items in this regard. Here we report the most recent recommendations. Methods The recommendations of the DGI are part of the "Klug entscheiden" initiative of the German Society of Internal Medicine (DGIM). Topics for the new items were suggested by members of the DGI, checked for scientific evidence and consented within the DGI and the DGIM before publication. Results The new recommendations are: (1) individuals with immune-suppression, advanced liver cirrhosis or renal insufficiency should receive a dual pneumococcal vaccination. (2) In case of positive blood cultures with Candida spp. thorough diagnostics and treatment should be initiated. (3) In case of suspected meningitis, adult patients should receive dexamethasone and antibiotics immediately after venipuncture for blood cultures and before potential imaging. (4) In case of suspected meningitis a CT scan before lumbar puncture should not be ordered-except for symptoms indicating high CSF pressure or focal brain pathology or in cases of severe immune-suppression. (5) In patients with suspected severe infections, a minimum of two pairs of blood cultures should be drawn using separate venipunctures prior to antibiotic therapy-regardless of body temperature. There is no need of a minimum time interval in between the blood draws. Conclusion Applying these new Choosing Wisely ® recommendations will increase patient safety and the value of health care.

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“…The recommendations on vaccination with anti-CD20 therapies could be extrapolated to anti-CD19 targeted agents such as blinatumomab. 28 Live vaccines for infants born from mothers on CD19 targeted agents should be postponed until B cell recovery. 105 Anti-CD20 monoclonal antibodies Tetanus immunoglobulin should be administered in patients with contaminated wounds who have received anti-CD20 monoclonal antibodies in the past six months.…”

Section: Cd19-targeted Agentsmentioning

confidence: 99%

“…98 Administration of second booster dose of inactivated influenza vaccine is associated with superior immunity response. 28 Non-immunized patients who are candidates for R-CHOP therapy should complete HBV vaccines ≥ 4 weeks prior to the initiation of rituximab. 14 Case reports have demonstrated that immunization of infants born from mothers on rituximab therapy up to the third trimester was not attenuated.…”

Section: Cd19-targeted Agentsmentioning

confidence: 99%

<p>Prevention Strategies to Minimize the Infection Risk Associated with Biologic and Targeted Immunomodulators</p>

Kordzadeh-Kermani

Khalili

Karimzadeh

et al. 2020

IDR

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The introduction of biologic and targeted immunomodulators is a significant breakthrough in the therapeutic area of various fields of medicine. The occurrence of serious infections, a complication of secondary immunosuppression associated with these agents, leads to increased morbidity and mortality. Implementing preventive strategies could minimize infection-related complications and improve therapeutic outcomes. The purpose of this review is to focus on current evident approaches regarding screening, monitoring, preventing (immunization and chemoprophylaxis), and management of infections in patients who are candidates for about 70 biologic and targeted immunomodulators. Recommendations are based on relevant guidelines, especially the ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document series published in 2018.

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Anti-infective vaccination strategies in patients with hematologic malignancies or solid tumors—Guideline of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO)

Cited by 73 publications

References 130 publications

Revaccination in Children Undergoing Autologous Hematopoietic Stem Cell Transplantation: Results of a Survey in Germany, Austria and Switzerland

Revaccination in Children Undergoing Autologous Hematopoietic Stem Cell Transplantation: Results of a Survey in Germany, Austria and Switzerland

Update on the “Choosing Wisely” initiative in infectious diseases in Germany

<p>Prevention Strategies to Minimize the Infection Risk Associated with Biologic and Targeted Immunomodulators</p>

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