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Study of Immune Responses to Influenza Vaccination With or Without Imiquimod Application in Untreated CLL Patients (CLLIFVAC)

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified November 2012 by The Royal Bournemouth Hospital.
Recruitment status was:  Active, not recruiting
CLL Topics, Inc.
Information provided by (Responsible Party):
Helen McCarthy, The Royal Bournemouth Hospital Identifier:
First received: January 8, 2008
Last updated: November 29, 2012
Last verified: November 2012

The purpose of the study is to determine whether it is possible to improve the immune response rate to 'flu vaccination in patients with chronic lymphocytic leukaemia (CLL).

Annual flu vaccination is recommended for all patients with CLL because they are known to be susceptible to infections and particularly to chest infections that may occur as a complication of influenza. Protection against 'flu depends on patients having a high level of antibodies against the 'flu virus. Vaccination works by stimulating the immune system and thus boosting the levels of these protective antibodies.

CLL patients have weakened immune systems due to the leukaemia itself but also following chemotherapy. The exact cause of these immune defects is not known. However, CLL patients typically have low antibody levels and their immune cells may not work normally.

Unfortunately, studies have shown that patients with CLL are not very good at making antibodies to 'flu vaccination and as a result protection against flu is not very reliable. Recent studies have shown that only 15-20 % of CLL patients will achieve a protective antibody level.

Recently a new type of medical cream has been introduced to treat certain skin conditions. Its name is Imiquimod and it is licensed to treat viral warts in the genital area and a type of skin cancer called basal cell carcinoma. It works by increasing the immune response in the skin. Animal studies have shown that as well as increasing immunity against viruses and cancers, it increases responses to vaccination when applied at the site of vaccination.

In this study we propose to test whether this new medicine can improve the response to the 'flu jab.

Condition Intervention Phase
Chronic Lymphocytic Leukemia
Drug: Imiquimod cream
Drug: influenza vaccine
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Factorial Assignment
Masking: Open Label
Primary Purpose: Prevention
Official Title: A Randomized Phase II Trial to Determine Whether the Application of Imiquimod Cream to the Vaccination Site Can Improve the Immune Responsiveness to Influenza Vaccination in Patients With Untreated Chronic Lymphocytic Leukemia

Resource links provided by NLM:

Further study details as provided by The Royal Bournemouth Hospital:

Primary Outcome Measures:
  • Immune responses to influenza vaccine in CLL cohorts and healthy age matched controls [ Time Frame: Dec 2009 ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Investigate immune responses and correlate with CLL prognostic markers [ Time Frame: Dec 2009 ] [ Designated as safety issue: No ]

Estimated Enrollment: 102
Study Start Date: October 2007
Estimated Study Completion Date: December 2013
Estimated Primary Completion Date: December 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Group A CLL patients
Vaccination with current trispecific influenza vaccine Day 1
Drug: influenza vaccine
trispecific influenza vaccine 0.5 ml subcutaneously
Other Name: influvac sub-unit
Experimental: Group B CLL patients
Vaccination with current trispecific influenza vaccine Day 1, together with the application of Imiquimod cream to the vaccination site on day 2 to 6.
Drug: Imiquimod cream
Imiquimod (aldara) 0.5 % cream to site of vaccination on day 2 to 6
Other Name: Aldara cream
Drug: influenza vaccine
trispecific influenza vaccine 0.5 ml subcutaneously
Other Name: influvac sub-unit
Active Comparator: Group C volunteers
Vaccination with current trispecific influenza vaccine Day 1
Drug: influenza vaccine
trispecific influenza vaccine 0.5 ml subcutaneously
Other Name: influvac sub-unit

Detailed Description:

Trial Summary

68 patients with stage A CLL who have not been treated, and 34 healthy age and sex matched volunteers who fulfil the entry requirements will be identified and invited to take part in this study.

Blood samples will be taken for baseline studies [FBC, U&E, LFT, Immunoglobulins (Igs), haemagglutinin titres] (20 mls) and T cells studies (50 mls to be frozen).If CLL prognostic factors have not already been determined a further 20ml will be taken for these.

Patients will be randomized to either:

Group A Vaccination with current trispecific influenza vaccine Day 1


Group B Vaccination with current trispecific influenza vaccine Day 1, together with the application of Imiquimod cream to the vaccination site on day 2 to 6.

Blood samples will be taken on day 0 for haemagglutinin studies (20 ml) and T cells (50ml to be frozen), then on day 7, 14 for T-cell studies (50 ml) and day 28 for haemagglutinin studies (20 ml). During the 28 days that subjects participate in the trial approximately 190 ml will be taken in total.

Antibody and T-cell responses to influenza virus will be assessed and compared between the two patient arms of the study and the control group.


Ages Eligible for Study:   Child, Adult, Senior
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Untreated stage A CLL patients
  • Healthy volunteers

Exclusion Criteria:

  • Patients with other malignancies
  • Patients receiving corticosteroids or other immunosuppressive drugs
  • Patients who have received vaccination against influenza in the past 6 months
  • Patients who have had an allergic reaction to a flu shot in the past, or have an allergy to eggs or who previously developed Guillain-Barré syndrome within 6 weeks of getting a flu shot
  • Patients failing to give informed consent.
  • Patients using homeopathic remedies such as echniaea cream.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00596336

United Kingdom
Royal Bournemouth hospital
Bournemouth, Dorset, United Kingdom, BH7 7DW
Sponsors and Collaborators
The Royal Bournemouth Hospital
CLL Topics, Inc.
Principal Investigator: Helen McCarthy, MBBS PhD Royal Bournemouth Hospital
  More Information

Responsible Party: Helen McCarthy, Haematology Consultant, The Royal Bournemouth Hospital Identifier: NCT00596336     History of Changes
Other Study ID Numbers: Eudract number: 2006-004902-16  LREC number: 06/Q2201/143 
Study First Received: January 8, 2008
Last Updated: November 29, 2012
Health Authority: United Kingdom: Medicines and Healthcare Products Regulatory Agency

Additional relevant MeSH terms:
Leukemia, Lymphoid
Leukemia, Lymphocytic, Chronic, B-Cell
Neoplasms by Histologic Type
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Leukemia, B-Cell
Immunologic Factors
Physiological Effects of Drugs
Adjuvants, Immunologic
Antineoplastic Agents
Interferon Inducers processed this record on December 08, 2016