Disclosures: Pergam reports grants from Global Life Technologies and vaccines for NIH-supported clinical trials from Chimerix, Merck and Sanofi outside the submitted work. Krantz reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
August 23, 2021
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Many patients with cancer lack adequate immunity to measles, mumps

Disclosures: Pergam reports grants from Global Life Technologies and vaccines for NIH-supported clinical trials from Chimerix, Merck and Sanofi outside the submitted work. Krantz reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Many individuals with cancer lack adequate immune defense against the measles and mumps viruses, according to a study conducted by researchers at Fred Hutchinson Cancer Research Center and published in JAMA Network Open.

Particularly at risk are young adults and recipients of bone marrow transplants, results showed.

Many individuals with cancer lack adequate immune defense against the measles and mumps viruses.
Data derived from Marquis SR, et al. JAMA Netw Open. 2021;doi:10.1001/jamanetworkopen.2021.18508.

“Our findings really emphasize the need to increase immunity at the community level, particularly among health care workers or caregivers who have frequent contact with [patients with cancer], in order to protect this vulnerable population,” Elizabeth M. Krantz, MS, biostatistician at Fred Hutch and co-senior author of the study, said in a press release.

In the cross-sectional study, Krantz and colleagues evaluated residual clinical plasma samples acquired in August 2019 from consecutive patients with cancer at Seattle Cancer Care Alliance/Fred Hutchinson Research Center. 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, sex, self-reported race/ethnicity, primary disease, treatment with chemotherapy within the past 30 days before sample collection, hematopoietic stem cell transplant history, and date of most recent 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% had a hematologic 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 overall population and among demographic and clinical subgroups.

Results showed overall seroprevalences 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 hematologic malignancies had the lowest seroprevalences of measles (0.63) and mumps (0.48) antibodies. Other groups with low seroprevalence 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).

The researchers expressed concern that the COVID-19 pandemic has slowed progress in childhood vaccinations that limited measles and mumps outbreaks. In recent years, childhood immunization rates for measles, mumps and rubella have declined in parts of the U.S., they noted.

“People have stopped going to doctor’s appointments, and we’ve stopped sending people out into the field to vaccinate children. My worry is that measles outbreaks are going to happen throughout the world because we have not addressed this, or put resources into it,” Steven A. Pergam, MD, MPH, infectious disease specialist at Fred Hutch, medical director of infection prevention at Seattle Cancer Care Alliance, and co-senior author of the study, said in the press release. “Mumps and measles outbreaks are potentially something that will be in our future if we don’t catch up with vaccines.”

In reviewing their findings, the researchers hypothesized that the low rates of immunity against measles and mumps among young people in the study may be driven by the types of cancers prevalent in these age groups, including hematologic malignancies.

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

References:

Fred Hutch. One in four cancer patients lack sufficient immunity against measles and mumps, study finds. Available at: www.fredhutch.org/en/news/releases/2021/07/One-in-four-cancer-patients-lack-sufficient-immunity-against-measles-and-mumps-study-finds.html. Accessed Aug. 5, 2021.
Marquis SR, et al. JAMA Netw Open. 2021;doi:10.1001/jamanetworkopen.2021.18508.