12th Congress of the European Hematology ... - Haematologica

3H-thymidine uptake in cell cultures. Results. Data are available on 30
individuals. Twenty four patients had a diagnosis of myeloma and 6 CLL.
The median age was 64 years (range 51-75). Six patients had never
required treatment. The median number of prior chemotherapeutic treatments
was 2 (range 0-5). Seventeen patients had undergone a transplant
procedure. The median time from last treatment was 14.5 months (range
6-69). Eight patients with myeloma were receiving maintenance thalidomide.
Two patients had low baseline total IgG levels, 11 low IgM and 8
low IgA. Prior to vaccination, the median number of serotypes per patient
with protective antibody levels was 1 in Group 1 [n=20], (range 0-6) and
4 in Group 2 [n=10], (range 0-7). Following vaccination the median number
of serotypes with protective antibody levels increased to 5 in Group
1 (range 1-7). 45% of patients achieved an adequate response. In Group
2 the median number of serotypes with protective levels remained at 4
(range 0-7). The proportion of patients with an adequate response did not
increase. In preliminary experiments, 5 individuals had cellular responses
evaluated. Proliferative responses to the protein conjugate were
observed only in those who subsequently developed a protective antibody
response (3 individuals). Conclusions. The pneumococcal conjugate
vaccine Prevenar appears to be immunogenic in patients naïve to PsV;
however it does not benefit those previously immunised with PsV.
0212
DIAGNOSING LATENT TUBERCULOSIS INFECTION IN PATIENTS WITH HAEMATHOLOGICAL
MALIGNANCIES: USE OF THE NEW T-CELL INTERFERON- RELEASE ASSAYS
A. Ferrari, 1 A. Ferrari, 2 M. Losi, 2 F. Luppi, 2 M. Meacci, 2 B. Meccugni, 2
F. Rumpianesi, 2 R. Marasca, 2 M. Luppi, 2 L. Richeldi, 2 L.M. Fabbri, 2
G. Torelli, 2
1 2 Division of Hematology, MODENA; University of Modena and Reggio
Emilia, MODENA, Italy
Background. patients with haematological malignancies have an
increased risk of progression to active tuberculosis (TB), and TB mortality.
The standard diagnostic test for latent tubercolosis infection (LTBI),
the tuberculin skin test (TST), may be unreliable in immunosuppressed
patients. T-cell interferon-γ (IFN-γ) release assays (TIGRAs) QuantiFER-
ON-TB Gold In tube (QFT-IT) and T-SPOT.TB (TS.TB) hold promise to
provide a more accurate diagnosis of LTBI. Blood tests are based on
detection of IFN-γ produced by T cells in response to antigen specific M.
tuberculosis antigens encoded by the RD1 region. Methods. between
February 1st 2006 and February 1st 2007 96 patients (mean age 61.3±14.5
years) have been blindly tested with TST, QFT-IT and TS.TB at the time
of first diagnosis, about at half of the chemotherapy course and 1 month
at least after treatment completion. Results. patients were affected by
non Hodgkin’s lymphoma (n=46), chronic lymphocytic leukemia (n=31),
Hodgkin’s disease (n=8), multiple myeloma (n=7), idiopathic myelofibrosis
(n=1), myelodysplastic syndrome (n=1), hairy cell leukaemia (n=1)
and systemic amyloidosis (n=1). Patients were treated according to current
institutional protocol. Two patients were excluded due to high background
levels with QFT-IT and 1 with TS.TB. At enrolment, 10/96
(10.4%), 21/94 (22.3%, p