Phase II Study of the Efficacy of the Pneumococcal Pneumonia Vaccine Series in Patients With Chronic Lymphocytic Leukemia Associated Immunodeficiency (PROTECT CLL)
Summary
This phase II trial tests whether the pneumococcal pneumonia vaccine series (PCV20 and PPSV23) works to mount an effective immune response in patients with chronic lymphocytic leukemia. PCV20 and PPSV23 are both vaccines that protect against bacteria that cause pneumococcal disease. Giving these vaccinations as series may make a stronger immune response and prevent against pneumococcal infections in patients with chronic lymphocytic leukemia. This is a single-center trial, conducted at Huntsman Cancer Institute.
Arms & interventions
- BiologicalPneumococcal 20-valent Conjugate Vaccine
Given IM
- BiologicalPneumococcal Polyvalent Vaccine
Given IM
Outcome measures
Primary
Proportion of patients who achieve the protocol defined change in antibody titers
Will examine the proportion of patients who achieve the protocol defined change in antibody titers from baseline in at least 10 of 19 S.pneumoniae serotypes shared between pneumococcal 20-valent conjugate vaccine (PCV20) and pneumococcal polyvalent vaccine (PPSV23) at Study Visit 2 and 3. The observed proportion and an exact 95% binomial confidence interval will be reported. A one sample exact binomial test will be performed at one-sided alpha = 0.05. The null hypothesis is that the proportion is 50% or lower.
Time frame: At 30 and 90 days post-PCV20 vaccination
Secondary
Proportion of patients who have a two-fold increase of immunoglobulin levels
Time frame: Up to 5 years post- PPSV23 vaccination
Proportion of vaccinated patients who have a two-fold increase in at least 10 of 19 S. pneumonia serotypes shared between PCV20 and PPSV23 vaccines
Time frame: Up to 5 years post PPSV23 vaccination
Proportion of patients who have a two-fold increase in antibody titers to an individual serotype vaccination
Time frame: At 30 and 90 days post-PCV20 vaccination
Proportion of patients who maintain adequate immune response
Time frame: Up to 5 years post PPSV23 vaccination
Eligibility criteria
Study locations (1)
Huntsman Cancer Institute/University of Utah
Salt Lake City, Utah, 84112
References
- Howlader N, Noone A, Krapcho M, et al. SEER Cancer Statistics Review, 1975-2016. Vol. 2020. Bethesda, MD: National Cancer Institute; 2019.
- FAIRLEY GH, SCOTT RB. Hypogammaglobulinaemia in chronic lymphatic leukaemia. Br Med J. 1961 Oct 7;2(5257):920-4. doi: 10.1136/bmj.2.5257.920. No abstract available.(PubMed)
- Ravandi F, O'Brien S. Immune defects in patients with chronic lymphocytic leukemia. Cancer Immunol Immunother. 2006 Feb;55(2):197-209. doi: 10.1007/s00262-005-0015-8. Epub 2005 Jul 16.(PubMed)
- Molica S, Levato D, Levato L. Infections in chronic lymphocytic leukemia. Analysis of incidence as a function of length of follow-up. Haematologica. 1993 Nov-Dec;78(6):374-7.(PubMed)
- Morrison VA. Infectious complications of chronic lymphocytic leukaemia: pathogenesis, spectrum of infection, preventive approaches. Best Pract Res Clin Haematol. 2010 Mar;23(1):145-53. doi: 10.1016/j.beha.2009.12.004.(PubMed)
- Rubin LG, Levin MJ, Ljungman P, Davies EG, Avery R, Tomblyn M, Bousvaros A, Dhanireddy S, Sung L, Keyserling H, Kang I; Infectious Diseases Society of America. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis. 2014 Feb;58(3):309-18. doi: 10.1093/cid/cit816.(PubMed)
- Sinisalo M, Aittoniemi J, Oivanen P, Kayhty H, Olander RM, Vilpo J. Response to vaccination against different types of antigens in patients with chronic lymphocytic leukaemia. Br J Haematol. 2001 Jul;114(1):107-10. doi: 10.1046/j.1365-2141.2001.02882.x.(PubMed)
- Itala M, Helenius H, Nikoskelainen J, Remes K. Infections and serum IgG levels in patients with chronic lymphocytic leukemia. Eur J Haematol. 1992 May;48(5):266-70. doi: 10.1111/j.1600-0609.1992.tb01805.x.(PubMed)
- Hartkamp A, Mulder AH, Rijkers GT, van Velzen-Blad H, Biesma DH. Antibody responses to pneumococcal and haemophilus vaccinations in patients with B-cell chronic lymphocytic leukaemia. Vaccine. 2001 Feb 8;19(13-14):1671-7. doi: 10.1016/s0264-410x(00)00409-6.(PubMed)
- Sinisalo M, Vilpo J, Itala M, Vakevainen M, Taurio J, Aittoniemi J. Antibody response to 7-valent conjugated pneumococcal vaccine in patients with chronic lymphocytic leukaemia. Vaccine. 2007 Dec 21;26(1):82-7. doi: 10.1016/j.vaccine.2007.10.053. Epub 2007 Nov 12.(PubMed)
- Pasiarski M, Rolinski J, Grywalska E, Stelmach-Goldys A, Korona-Glowniak I, Gozdz S, Hus I, Malm A. Antibody and plasmablast response to 13-valent pneumococcal conjugate vaccine in chronic lymphocytic leukemia patients--preliminary report. PLoS One. 2014 Dec 15;9(12):e114966. doi: 10.1371/journal.pone.0114966. eCollection 2014.(PubMed)
- Jackson LA, Gurtman A, Rice K, Pauksens K, Greenberg RN, Jones TR, Scott DA, Emini EA, Gruber WC, Schmoele-Thoma B. Immunogenicity and safety of a 13-valent pneumococcal conjugate vaccine in adults 70 years of age and older previously vaccinated with 23-valent pneumococcal polysaccharide vaccine. Vaccine. 2013 Aug 2;31(35):3585-93. doi: 10.1016/j.vaccine.2013.05.010. Epub 2013 May 18.(PubMed)
- Svensson T, Kattstrom M, Hammarlund Y, Roth D, Andersson PO, Svensson M, Nilsson I, Rombo L, Cherif H, Kimby E. Pneumococcal conjugate vaccine triggers a better immune response than pneumococcal polysaccharide vaccine in patients with chronic lymphocytic leukemia A randomized study by the Swedish CLL group. Vaccine. 2018 Jun 14;36(25):3701-3707. doi: 10.1016/j.vaccine.2018.05.012. Epub 2018 May 7.(PubMed)
- Cordonnier C, Labopin M, Chesnel V, Ribaud P, Camara Rde L, Martino R, Ullmann AJ, Parkkali T, Locasciulli A, Yakouben K, Pauksens K, Bonnet E, Einsele H, Niederwieser D, Apperley J, Ljungman P. Immune response to the 23-valent polysaccharide pneumococcal vaccine after the 7-valent conjugate vaccine in allogeneic stem cell transplant recipients: results from the EBMT IDWP01 trial. Vaccine. 2010 Mar 24;28(15):2730-4. doi: 10.1016/j.vaccine.2010.01.025. Epub 2010 Jan 29.(PubMed)
- Chan CY, Molrine DC, George S, Tarbell NJ, Mauch P, Diller L, Shamberger RC, Phillips NR, Goorin A, Ambrosino DM. Pneumococcal conjugate vaccine primes for antibody responses to polysaccharide pneumococcal vaccine after treatment of Hodgkin's disease. J Infect Dis. 1996 Jan;173(1):256-8. doi: 10.1093/infdis/173.1.256.(PubMed)