Compared with healthy persons, those with myeloproliferative neoplasms (MPNs) exhibited a different response following immunization with the inactivated influenza A vaccine, according to results of a small study published in the British Journal of Haematology.

The Philadelphia chromosome-negative MPNs, including polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis, are characterized by the clonal expansion of 1 or more hematopoietic cell lineages.

Although the annual influenza A vaccination is frequently recommended for patients with MPNs, data are limited regarding the efficacy of the vaccine in this population of patients compared with healthy persons.

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“Vaccination should result in memory B- and T-cell formation which facilitates adaptive immune responses to the pathogen if challenged later and can take approximately 2 weeks for a so-called ’healthy’ immune system,” the study investigators noted.  

In this study, which enrolled 25 patients and was conducted at King’s College Hospital, London, United Kingdom, peripheral blood specimens were collected prior to vaccination, and at 3 weeks and 3 months following vaccination for 19 patients with MPNs and 6 healthy donors. Deep immunophenotyping using high-dimensional single-cell analysis with mass spectrometry was performed on peripheral blood mononuclear clear cells isolated from these samples.

Results of comparisons of specimens from healthy donors with those from patients with MPNs included:

  • Prevaccination specimens showed significantly fewer naïve CD4 T-cells (P =.01) and activated CD4 T-cells (P =.02) in patients with MPNs
  • 3-week postvaccination, specimens of patients with MPNs showed significantly fewer memory cell clusters, including central memory CD4 cells (P =.00693) and central memory CD8 cells (P =.00511), as well as memory B cells (P =.01-.05, depending on specific cell type) and resting memory B cells (P =.05)
  • 3-week postvaccination specimens of patients with MPNs had significantly fewer Treg B cells (P =.01)
  • 3-week postvaccination specimens showed significantly more naïve CD4 T-cells (P =.00693) in patients with MPNs, possibly indicating delayed immune response in this group
  • Significantly fewer memory B cells (P =.01-.04, depending on cell type) and Treg B cells (P =.01) were still observed 3 months following vaccination in specimens from patients with MPNs

“Our data support routine influenza A immunization in accordance with national recommendations; however, additional studies are mandated to evaluate both the effectiveness of the vaccine responses and ‘memory’ in a larger cohort of MPN patients to determine if alternative strategies for vaccination are required,” noted the study investigators.

Disclosures: Multiple authors declared affiliation with or received funding from the pharmaceutical industry. Please refer to the original article for a full list of disclosures.


Alimam S, Timms JA, Harrison CN, et al. Altered immune response to the annual influenza A vaccine in patients with myeloproliferative neoplasms.Br J Haematol. Published online November 7, 2020.  doi:10.1111/bjh.17096