Vaccination in CLL
Live vaccines, including that for Herpes Zoster Virus (HSV), should be avoided in immunocompromised patients.
In any patient with CLL who has had HSV, prophylactic acyclovir should be continued indefinitely
Recommended Vaccination
Patients should ideally be vaccinated at diagnosis and before treatment
- Pneumococcal Conjugate Vaccine (PCV13 or Prenvar 13® )
- Haemophilus Influenzae B
and then at least two months later
- Pneumococcal Polysaccharide Vaccine (PPV23 or Pneumovax® )
Response should be assessed with antibody titres (6 months after the second dose)
Response with serotype specific pneumococcal and HiB antibodies will be checked in the haematology department for those patients attending outpatients. Please check these in primary care if they are not being referred for specialist review.
Loss of response may necessitate re-vaccination
- Annual Influenza vaccine should also be given
References:
BSH Guideline for treatment of CLL, July 2018 : www.onlinelibrary.wiley.com/doi/full/10.1111/bjh.15460
Contributors:
Dr Richard Noble, Consultant Haematologist, RCHT
Dr Bridgitte Wesson, GP & Kernow RMS Haematology guideline lead
Review date: 13/07/2020
Next Review date: 13/07/2021