From the Guidelines
A history of cancer alone does not necessarily make a patient immunocompromised, but many cancer treatments and certain types of cancer can significantly suppress the immune system. The degree and duration of immunosuppression varies based on the specific treatment, dosage, duration, and the patient's baseline health status 1. Some patients may remain immunocompromised for months after completing treatment, while others recover immune function more quickly.
Key Factors to Consider
- Certain cancers themselves, particularly hematologic malignancies like leukemia, lymphoma, and multiple myeloma, can directly impair immune function by disrupting normal blood cell production and immune cell function 1.
- Chemotherapy regimens often reduce white blood cell counts, particularly neutrophils, leaving patients vulnerable to infections 1.
- Radiation therapy can also deplete immune cells when bone marrow is within the radiation field 1.
- Certain targeted therapies and immunotherapies may alter immune function as well 1.
Vaccination Recommendations
- Annual vaccination against influenza with the inactivated influenza virus is recommended for all individuals at increased risk due to immunosuppression 1.
- The NCCN panel recommends that patients with cancer receive the influenza, COVID-19, pneumococcal vaccines 1.
- Patients receiving lymphocyte or plasma cell-depleting regimens should delay COVID-19 vaccination for at least 3 months following the end of their immunotherapeutic treatment to get the best antibody response 1.
Conclusion Not Applicable, Direct Answer Only
It is essential to consider both the specific cancer type and treatment history to accurately assess a patient's immunocompetence status. This assessment is crucial for preventing and managing infections in patients with a history of cancer 1.
From the Research
Cancer History and Immunocompromised Status
- A cancer history can make a patient immunocompromised, as evidenced by the need for Pneumocystis pneumonia (PCP) prophylaxis in patients with cancer undergoing intensive chemotherapy regimens 2, 3, 4.
- Patients with cancer, particularly those with leukemia and lymphoma, are at risk of developing PCP, a life-threatening infection 2, 3, 4.
- The use of trimethoprim/sulfamethoxazole (TMP/SMX) as PCP prophylaxis is common in patients with cancer, and various dosing regimens have been studied, including daily, thrice weekly, twice weekly, and once weekly administration 2, 3, 4, 5.
Immunocompromised Status and Cancer
- Immunocompromised patients are prone to develop certain malignancies, particularly involving cells of the immune system itself 6.
- Cancer history can contribute to immunocompromised status, making patients more susceptible to infections such as PCP 2, 3, 4.
- The relationship between cancer history and immunocompromised status is complex, and further study is needed to understand the underlying mechanisms and to develop effective prevention and treatment strategies 2, 3, 4, 5, 6.