I finished R-CHOP chemotherapy for non-Hodgkin’s lymphoma 4 months ago (now in remission). I take 2 antiviral tablets daily. Is the shingles vaccine recommended for me?
First of all, it must be clarified that both the treatment according to the R-CHOP scheme, which is a chemo-immunotherapy, and the haematological neoplasm itself for which the treatment is started, i.e. non-Hodgkin’s lymphoma, favor the patient’s immunocompromise, with a risk of developing Herpes Zoster at least double if not three times that of the general population of the same age and condition.
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Having also available in Italy an inactivated recombinant adjuvanted vaccine which has shown to be very effective and at the same time to have a particularly favorable safety profile, even in patients of the same type, the recommendation for the vaccination of immuno-compromised subjects is strong , as also confirmed by the recent SIMIT Recommendations for vaccinations. It must be said that, although there is not currently available specific solid data deriving from a clinical trial on this precise type of onco-haematological patient affected by non-Hodgkin’s lymphoma treated with chemo-immunotherapy, a study has been published on haematological patients in general ( Zoster-039) which in the post-hoc efficacy evaluation also includes non-Hodgkin’s lymphoma.
Herpes zoster
It is also important to underline that, in consideration of the characteristics of the patient, the disease, the therapies related to it (for example the rituximab, anti-CD20 monoclonal antibody) and the impact on the immune system, there may be a limited or reduced response, but despite this, the opinion of us hematologists is absolutely favourable.
* Claudio Cerchione is Specialist in Hematology at the IRCCS Romagna Institute for the Study of Tumors “Dino Amadori” – IRST