TY - JOUR
T1 - Invasive pneumococcal disease among adults with hematological and solid organ malignancies: A population-based cohort study
AU - Garcia Garrido, Hannah M.
AU - Knol, Mirjam J.
AU - Heijmans, Jarom
AU - van Sorge, Nina M.
AU - Sanders, Elisabeth A. M.
AU - Klümpen, Heinz-Josef
AU - Grobusch, Martin P.
AU - Goorhuis, Abraham
N1 - Funding Information: This work was supported by a public research grant of ZonMW (grant number 522004005) . The funder of the study had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. Publisher Copyright: © 2021 The Authors
PY - 2021/5/1
Y1 - 2021/5/1
N2 - Objectives: To determine the risk of invasive pneumococcal disease (IPD) in adult cancer patients stratified by type of underlying malignancy, age, and capsular serotype and to assess herd effects of childhood pneumococcal vaccination. Methods: All adult IPD cases reported to the Dutch pneumococcal surveillance system between 2004 and 2016 were included in this study. IPD incidence rates (IR) stratified by subtype of malignancy were calculated per 100 000 patient-years of follow-up. Incidence rate ratios (IRR) were calculated to compare IRs between groups. Results: A total of 7167 IPD cases were included, of which 1453 were in patients with malignancies. For patients with hematological malignancies (HM) and solid organ malignancies (SOM), IRs were 482/100 000 and 79/100 000, respectively, compared with 15/100 000 in controls. The highest incidence was observed among patients with multiple myeloma, non-Hodgkin lymphoma, chronic lymphocytic leukemia, pancreatic cancer, and lung cancer (3299/100 000, 2717/100 000, 538/100 000, 559/100 000, and 393/100 000, respectively), and in patients ≥50 years old. Among HM patients, the incidence of IPD declined significantly after the implementation of infant pneumococcal vaccination (IRR 0.65, 95% confidence interval 0.51–0.84); among SOM patients, the decline was not statistically significant (IRR 0.88, 95% confidence interval 0.72–1.07). Conclusions: The IPD disease burden in cancer patients remains high. Large differences in IPD incidence between the different types of cancer demand tailored guidance regarding pneumococcal vaccination.
AB - Objectives: To determine the risk of invasive pneumococcal disease (IPD) in adult cancer patients stratified by type of underlying malignancy, age, and capsular serotype and to assess herd effects of childhood pneumococcal vaccination. Methods: All adult IPD cases reported to the Dutch pneumococcal surveillance system between 2004 and 2016 were included in this study. IPD incidence rates (IR) stratified by subtype of malignancy were calculated per 100 000 patient-years of follow-up. Incidence rate ratios (IRR) were calculated to compare IRs between groups. Results: A total of 7167 IPD cases were included, of which 1453 were in patients with malignancies. For patients with hematological malignancies (HM) and solid organ malignancies (SOM), IRs were 482/100 000 and 79/100 000, respectively, compared with 15/100 000 in controls. The highest incidence was observed among patients with multiple myeloma, non-Hodgkin lymphoma, chronic lymphocytic leukemia, pancreatic cancer, and lung cancer (3299/100 000, 2717/100 000, 538/100 000, 559/100 000, and 393/100 000, respectively), and in patients ≥50 years old. Among HM patients, the incidence of IPD declined significantly after the implementation of infant pneumococcal vaccination (IRR 0.65, 95% confidence interval 0.51–0.84); among SOM patients, the decline was not statistically significant (IRR 0.88, 95% confidence interval 0.72–1.07). Conclusions: The IPD disease burden in cancer patients remains high. Large differences in IPD incidence between the different types of cancer demand tailored guidance regarding pneumococcal vaccination.
KW - Cancer
KW - Epidemiology
KW - Immunocompromised host
KW - Pneumococcal disease
KW - Streptococcus pneumoniae
KW - Vaccination
UR - http://www.scopus.com/inward/record.url?scp=85104337747&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ijid.2021.03.072
DO - https://doi.org/10.1016/j.ijid.2021.03.072
M3 - Article
C2 - 33781907
SN - 1201-9712
VL - 106
SP - 237
EP - 245
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -