Cancer Research Lab

Neuraminidase inhibitors, which include oseltamivir and zanamivir, improve outcomes in leukemia patients with influenza, according to a report in the April 1st issue of Clinical Infectious Diseases.

“I think all immunocompromised patients or patients with co-morbidities (including elderly) should be treated with neuraminidase inhibitors if they are diagnosed with influenza,” Dr. Roy F. Chemaly from The University of Texas M. D. Anderson Cancer Center, Houston, said.

Dr. Chemaly and associates studied the impact of neuraminidase inhibitor therapy on the outcome of 33 patients with leukemia who contracted influenza.

Only 1 of 14 patients treated with neuraminidase inhibitor therapy while they had upper respiratory symptoms went on to develop pneumonia, the authors report, and the infection resolved after treatment with oseltamivir plus ribavirin.

Three of 8 patients not treated with neuraminidase inhibitor therapy died of influenza, the results indicate, compared with none of the 25 patients who received neuraminidase inhibitor therapy. All three of the patients who died had influenza B.

There were no major or moderate adverse effects during neuraminidase inhibitor therapy, the researchers note.

“We also found that lymphopenia at the time of presentation may identify patients with leukemia who are at high risk for the development of pneumonia,” the investigators say.

“Prevention, i.e., vaccination, is still very crucial, but unfortunately our immunocompromised patients respond poorly to vaccination, which will provide suboptimal protection or no protection at all against this infection,” Dr. Chemaly pointed out .

“What I would like to look at next is the difference in outcomes (especially morbidity) in patients infected with influenza A versus B,” Dr. Chemaly added. “The other thing that I would like to investigate is the impact of neuraminidase inhibitor prophylaxis on leukemia patients.”