Seroprevalence of Measles and Mumps Antibodies Among Individuals With Cancer

Abstract

IMPORTANCE Although patients with cancer are at an increased risk of infection-related complications, few studies have characterized their vulnerability to measles and mumps. Given the recent outbreaks and increased community vaccine hesitancy, understanding measles and mumps immunity within this population is vital. OBJECTIVESTo identify a point prevalence estimate of protective measles and mumps antibodies among ambulatory patients with cancer. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study, residual clinical plasma samples were obtained from consecutive patients with cancer at Seattle Cancer Care Alliance/Fred Hutchinson Cancer Research Center in Seattle, Washington, in August 2019. These samples were tested for measles and mumps IgG using a commercial enzyme-linked immunosorbent assay. Patients without cancer were excluded from the analysis. EXPOSURES Patient age, sex, self-reported race and ethnicity, primary disease, receipt of chemotherapy in the past 30 days before sample collection, hematopoietic cell transplant (HCT) history, and date of most recent intravenous immunoglobulin treatment were abstracted from electronic medical records. MAIN OUTCOMES AND MEASURES Measles and mumps IgG seroprevalence, defined as the proportion of patients with positive antibody test results, was measured overall and among the subgroups. RESULTSOf the 959 patients included in the analysis, 510 (53%) were male individuals and the mean (SD) age at sample collection was 60 (15) years. Most patients (576 [60%]) had a malignant solid tumor, and 383 patients (40%) had a hematologic malignant neoplasm; 146 patients (15%) had an HCT history. Overall, the seroprevalence of measles antibodies was 0.75 (95% CI, 0.72-0.78), and the seroprevalence of mumps antibodies was 0.62 (95% CI, 0.59-0.65). The lowest seroprevalences were among patients with a hematologic malignant neoplasm (0.63 for measles and 0.48 for mumps), those with a history of HCT (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). CONCLUSIONS AND RELEVANCEIn this study, 25% of ambulatory patients with cancer lacked protective antibodies for measles and 38% lacked protective antibodies for mumps. Deficits in protective antibodies underscore patients' increased risk during outbreaks and emphasize the need for community-based efforts to increase herd immunity to protect this population.

Cellular and humoral immune response to mRNA COVID-19 vaccination in subjects with chronic lymphocytic leukemia

“…We explored recall response to measles, where we observed that 81% of subjects were seropositive for measles serum antibodies, two subjects (Subject 3 and 10) are currently on active treatment with bcl-2 inhibitor and BTKi respectively and one is treatment naïve. This is a slightly higher response rate than was observed in a recent cross-sectional study of 959 patients 24 which detected a 63% measles seropositivity rate in subjects with hematological malignancies. The antibody response to measles seems largely unaffected in CLL subjects, indicating that LLPCs responsible for maintaining circulating serum antibodies remain stable throughout CLL immune dysfunction and treatment.…”

Cellular and humoral Immune response to mRNA COVID-19 vaccination in subjects with chronic lymphocytic leukemia

“…Of those, two subjects (Subject 3 and 10) are currently on active treatment with bcl-2 inhibitor and BTKi respectively and one subject is treatment naïve. This is a slightly higher response rate than was observed in a recent cross-sectional study of 959 patients 34 which detected an overall 75% measles seropositivity rate in cancer subjects and lower (63% seropositivity) in those with hematological malignancies. Overall, the antibody response to measles seems largely unaffected in CLL subjects, indicating that long-lived plasma cells responsible for maintaining circulating serum antibodies remain stable throughout CLL immune dysfunction and treatment.…”

“…In this investigation, we explored the recall response to measles virus, a common childhood antigen exposed to either through vaccination or natural infection in subjects born before 1963. 34 Here, we observed that 81% of our subjects were seropositive for measles serum antibodies, with all but three subjects exhibiting a response above background (limit of detection). Of those, two subjects (Subject 3 and 10) are currently on active treatment with bcl-2 inhibitor and BTKi respectively and one subject is treatment naïve.…”

Successful restoration of protective immunity against measles, mumps, and rubella following MMR vaccination in adult hematopoietic cell transplant recipients

“…Twenty‐five percent of cancer patients lack protective antibodies for measles and 38% lack antibodies for mumps; furthermore, hematopoietic cell transplantation (HCT) is associated with 50% lower seroprevalence compared with cancer patients with no previous HCT 1 . The reported probability for being seronegative for measles, mumps, and rubella at 5 years after allogeneic HCT are 60, 73, and 52%, respectively; 2 and prior studies suggest that virus‐specific long‐term B‐cell memory function is not maintained, regardless of the immune status of the donor 2 …”