Immunogenicity and Safety of Seasonal Influenza Vaccination in Patients with Classic Kaposi's Sarcoma

Abstract

Classic Kaposi's sarcoma (cKS) is a human herpesvirus-8 (HHV-8)-associated lympho-angioproliferative tumor typically occurring in the elderly. It is associated with HHV-8-driven perturbed balance of peripheral B-cell subsets, which may have an impact on immune responses to antigenic stimulation. We took advantage of the common practice of cKS patients to undergo seasonal influenza vaccination because of advanced age and analyzed the immunogenicity and safety of licensed trivalent influenza vaccine in 46 cKS patients and 44 matched controls. Licensure criteria for immunogenicity were fulfilled in both groups. Four weeks after vaccination, hemagglutination-inhibition antibody titers against each viral strain contained in the vaccine increased in patients and controls (all P<0.001). Protection against at least one strain was achieved by 96% of cKS and 91% of control subjects. Protection against all strains persisted after 12 weeks, demonstrating a long-lasting response to vaccination. The vaccine was equally well tolerated by patients and controls, as assessed by evaluating solicited local and systemic reactions to the vaccine, and appearance or increase of antinuclear autoantibodies. HHV-8 virological rebound was observed in four cKS patients, but was not accompanied by progression of KS lesions. We conclude that seasonal influenza vaccine given to cKS patients is immunogenic and safe.

Enhanced phosphorylation of sphingosine and ceramide sustains the exuberant proliferation of endothelial progenitors in Kaposi sarcoma

“…The patients had histologically confirmed diagnosis of cKS, were positive for anti‐HHV8 antibody, negative for HIV, and were not in systemic chemotherapy. Their KS stage at the time of blood withdrawal was 1A, 1B, and 3B, respectively, according to our classification that takes into account the prevalent type of lesions, localization, evolutive pattern (A and B, indicating slowly and rapidly evolving disease), and presence of complications . Neither cKS patients nor controls had suffered from chronic inflammatory, autoimmune, and cancer disease other than KS, nor they had clinically evident infections.…”

“…Cells were maintained in EGM‐2 plus 5% FCS for 48 h, as previously reported . At the time of the experiment, the medium was gently removed and cells were then pulsed for 2 h with 20 nM [ 3 H]‐Sph (0.4 μCi/ml) (20 Ci/mmol, PerkinElmer Life Science) in EBM‐containing phosphatase inhibitors . At the end of pulse, the medium was carefully collected and centrifuged (500 g , 5 min at 4°C), and cells were scraped off the plate.…”

“…Their KS stage at the time of blood withdrawal was 1A, 1B, and 3B, respectively, according to our classification that takes into account the prevalent type of lesions, localization, evolutive pattern (A and B, indicating slowly and rapidly evolving disease), and presence of complications. 8,[14][15][16] Neither cKS patients nor controls had suffered from chronic inflammatory, autoimmune, and cancer disease other than KS, nor they had clinically evident infections. They were not under treatment with drugs that have been reported to affect the number and function of endothelial progenitor cells (including statins, angiotensin-converting enzyme inhibitors, calcium antagonists, and metformin).…”

COVID-19 Vaccination in Patients with Classic Kaposi’s Sarcoma

“…Considering the baseline clinical risk factors of patients with CKS, and the complex interplay of the two viral agents, in our opinion, SARS-CoV-2 vaccination should be strongly recommended among CKS patients. Previous evidence has supported the immunogenicity and safety of influenza vaccination in this subset of patients [34]. We therefore propose regular follow up of patients with CKS during the present COVID-19 pandemic, and global adhesion to the vaccination program, with periodic clinical, and possibly with serological monitoring of HHV8 DNA and antibodies before and after vaccine administration.…”

Increased Frequency and Vasculogenic Potential of Endothelial Colony-Forming Cells in Patients with Kaposi’s Sarcoma

“…All patients had histologically confirmed diagnosis of KS, positive test results for anti-HHV-8 antibody, and negative test results for HIV. Staging was performed in accordance with our classification, which takes into account the prevalent type of lesions, localization, clinical behavior, evolutive pattern (A and B, indicating slowly and rapidly evolving disease, respectively), and presence of complications (Brambilla et al, 2003;Cappelletti et al, 2012;Della Bella et al, 2006). Patients receiving systemic chemotherapy were excluded.…”