Pain management, supportive and palliative care in patients with renal cell carcinoma

BJU International

Volumn 99, Issue 5 B, 2007, Pages 1305-1312

  Turner, Jeffrey S ^a   Cheung, Eric M ^a   George, Jaya ^a   Quinn, David I ^a  

^a UNIVERSITY OF SOUTHERN CALIFORNIA   (United States)

Author keywords

Anaemia; Analgesia; Anorexia; Cachexia; Hypercalcaemia; Lethargy; Metastases; Radiation therapy; Venous thromboembolism

Indexed keywords

ALEDRONATE; ANTICONVULSIVE AGENT; ANTIDEPRESSANT AGENT; BISPHOSPHONIC ACID DERIVATIVE; CALCITONIN; CORTICOSTEROID; DIURETIC AGENT; ETODRONATE; GABAPENTIN; GESTAGEN; INTERLEUKIN 2; LOW MOLECULAR WEIGHT HEPARIN; MEDROXYPROGESTERONE ACETATE; MEGESTROL ACETATE; MITHRAMYCIN; NONSTEROID ANTIINFLAMMATORY AGENT; OPIATE; PAMIDRONIC ACID; PARACETAMOL; PROTEIN TYROSINE KINASE INHIBITOR; SORAFENIB; SUNITINIB; TEMSIROLIMUS; TRAMADOL; UNCLASSIFIED DRUG; VON HIPPEL LINDAU PROTEIN; WARFARIN; ZOLEDRONIC ACID;

ADD ON THERAPY; ADJUVANT THERAPY; ANALGESIA; ANEMIA; ANOREXIA; APPETITE; ARTIFICIAL EMBOLISM; BLOOD CLOT; BONE MARROW SUPPRESSION; BONE METASTASIS; BONE NECROSIS; BONE PAIN; BRAIN METASTASIS; CACHEXIA; CANCER IMMUNIZATION; CANCER PAIN; DEEP VEIN THROMBOSIS; DRUG DOSE ESCALATION; DYSPEPSIA; GAMMA KNIFE RADIOSURGERY; GASTROESOPHAGEAL REFLUX; GASTROINTESTINAL REFLUX; GENE; GENE MUTATION; HUMAN; HYPERCALCEMIA; KIDNEY CARCINOMA; LETHARGY; LUNG METASTASIS; MENTAL DISEASE; NAUSEA; PAIN ASSESSMENT; PALLIATIVE THERAPY; PARANEOPLASTIC SYNDROME; PATIENT COMPLIANCE; PERCUTANEOUS VERTEBROPLASTY; PRIORITY JOURNAL; PROTON THERAPY; REVIEW; SEDATION; SIDE EFFECT; SPINAL CORD COMPRESSION; SYSTEMIC THERAPY; UNSPECIFIED SIDE EFFECT; VENOUS THROMBOEMBOLISM; VON HIPPEL LINDAU GENE;

ANALGESICS; CARCINOMA, RENAL CELL; CHRONIC DISEASE; HUMANS; KIDNEY NEOPLASMS; NEOPLASM METASTASIS; PAIN; PALLIATIVE CARE; QUALITY OF LIFE;

EID: 34247249416     PISSN: 14644096     EISSN: 1464410X     Source Type: Journal    
DOI: 10.1111/j.1464-410X.2007.06829.x     Document Type: Review

References (106)

1. Onuma E, Tsunenari T, Saito H, Sato K, Yamada-Okabe H, Ogata E. Parathyroid hormone-related protein (PTHrP) as a causative factor of cancer-associated wasting: possible involvement of PTHrP in the repression of locomotor activity in rats bearing human tumor xenografts. Int J Cancer 2005; 116: 471-8
2. Cahlin C, Korner A, Axelsson H, Wang W, Lundholm K, Svanberg E. Experimental cancer cachexia: the role of host-derived cytokines interleukin (IL)-6, IL-12, interferon-γ, and tumor necrosis factor α evaluated in gene knockout, tumor-bearing mice on C57 Bl background and eicosanoid-dependent cachexia. Cancer Res 2000; 60: 5488-93
3. Weissglas MG, Schamhart DH, Lowik CW, Papapoulos SE, Theuns HM, Kurth KH. The role of interleukin-6 in the induction of hypercalcemia in renal cell carcinoma transplanted into nude mice. Endocrinology 1997; 138: 1879-85
4. Jatoi A, Egner J, Loprinzi CL et al. Investigating the utility of serum cytokine measurements in a multi-institutional cancer anorexia/weight loss trial. Support Care Cancer 2004; 12: 640-4
5. Negrier S, Maral J, Drevon M, Vinke J, Escudier B, Philip T. Long-term followup of patients with metastatic renal cell carcinoma treated with intravenous recombinant interleukin-2 in Europe. Cancer J Sci Am 2000; 6 (Suppl. 1): S93-8
6. Weissglas M, Schamhart D, Lowik C, Papapoulos S, Vos P, Kurth KH. Hypercalcemia and cosecretion of interleukin-6 and parathyroid hormone related peptide by a human renal cell carcinoma implanted into nude mice. J Urol 1995; 153: 854-7
7. Oster MH, Enders SR, Samuels SJ et al. Megestrol acetate in patients with AIDS and cachexia. Ann Intern Med 1994; 121: 400-8
8. Von Roenn JH, Armstrong D, Kotler DP et al. Megestrol acetate in patients with AIDS-related cachexia. Ann Intern Med 1994; 121: 393-9
9. Berenstein EG, Ortiz Z. Megestrol acetate for the treatment of anorexia-cachexia syndrome. Cochrane Database Syst Rev 2005; 2: CD004310
10. Pascual Lopez A, Roque i Figuls M, Urrutia Cuchi G et al. Systematic review of megestrol acetate in the treatment of anorexia-cachexia syndrome. J Pain Symptom Manage 2004; 27: 360-9
11. Gebbia V, Testa A, Gebbia N. Prospective randomised trial of two dose levels of megestrol acetate in the management of anorexia-cachexia syndrome in patients with metastatic cancer. Br J Cancer 1996; 73: 1576-80
12. Loprinzi CL, Michalak JC, Schaid DJ et al. Phase III evaluation of four doses of megestrol acetate as therapy for patients with cancer anorexia and/or cachexia. J Clin Oncol 1993; 11: 762-7
13. Loprinzi CL, Kugler JW, Sloan JA et al. Randomized comparison of megestrol acetate versus dexamethasone versus fluoxymesterone for the treatment of cancer anorexia/cachexia. J Clin Oncol 1999; 17: 3299-306
14. Cronin RE, Kaehny WD, Miller PD et al. Renal cell carcinoma: unusual systemic manifestations. Medicine (Baltimore) 1976; 55: 291-311
15. Gold PJ, Fefer A, Thompson JA. Paraneoplastic manifestations of renal cell carcinoma. Semin Urol Oncol 1996; 14: 216-22
16. Janik JE, Sznol M, Urba WJ et al. Erythropoietin production. A potential marker for interleukin-2/interferonresponsive tumors. Cancer 1993; 72: 2656-9
17. Wiesener MS, Seyfarth M, Warnecke C et al. Paraneoplastic erythrocytosis associated with an inactivating point mutation of the von Hippel-Lindau gene in a renal cell carcinoma. Blood 2002; 99: 3562-5
18. Lee YS, Vortmeyer AO, Lubensky IA et al. Coexpression of erythropoietin and erythropoietin receptor in von Hippel-Lindau disease-associated renal cysts and renal cell carcinoma. Clin Cancer Res 2005; 11: 1059-64
19. Nieken J, Mulder NH, Buter J et al. Recombinant human interleukin-6 induces a rapid and reversible anemia in cancer patients. Blood 1995; 86: 900-5
20. Nissenson RA, Strewler GJ, Williams RD, Leung SC. Activation of the parathyroid hormone receptor-adenylate cyclase system in osteosarcoma cells by a human renal carcinoma factor. Cancer Res 1985; 45: 5358-63
21. Thiede MA, Strewler GJ, Nissenson RA, Rosenblatt M, Rodan GA. Human renal carcinoma expresses two messages encoding a parathyroid hormone-like peptide: evidence for the alternative splicing of a single-copy gene. Proc Natl Acad Sci USA 1988; 85: 4605-9
22. Walther MM, Patel B, Choyke PL et al. Hypercalcemia in patients with metastatic renal cell carcinoma: effect of nephrectomy and metabolic evaluation. J Urol 1997; 158: 733-9
23. Kamai T, Arai K, Koga F et al. Higher expression of K-ras is associated with parathyroid hormone-related protein-induced hypercalcaemia in renal cell carcinoma. BJU Int 2001; 88: 960-6
24. Fahn HJ, Lee YH, Chen MT, Huang JK, Chen KK, Chang LS. The incidence and prognostic significance of humoral hypercalcemia in renal cell carcinoma. J Urol 1991; 145: 248-50
25. Harrison P. Update on pain management for advanced genitourinary cancer. J Urol 2001; 165: 1849-58
26. Portenoy RK, Lesage P. Management of cancer pain. Lancet 1999; 353: 1695-700
27. Zech DF, Grond S, Lynch J, Hertel D, Lehmann KA. Validation of World Health Organization Guidelines for cancer pain relief: a 10-year prospective study. Pain 1995; 63: 65-76
28. Santiago S, Ferrer T, Espinosa ML. Neurophysiological studies of thin myelinated (Aδ) and unmyelinated (C) fibers: application to peripheral neuropathies. Neurophysiol Clin 2000; 30: 27-42
29. Sugiura Y. Spinal organization of C-fiber afferents related with nociception or non-nociception. Prog Brain Res 1996; 113: 320-39
30. Ripamonti C, Fulfaro F. Malignant bone pain: pathophysiology and treatments. Curr Rev Pain 2000; 4: 187-96
31. Palecek J. The role of dorsal columns pathway in visceral pain. Physiol Res 2004; 53 (Suppl. 1): S125-30
32. Willis WD, Al-Chaer ED, Quast MJ, Westlund KN. A visceral pain pathway in the dorsal column of the spinal cord. Proc Natl Acad Sci USA 1999; 96: 7675-9
33. Jaeckle KA, Young DF, Foley KM. The natural history of lumbosacral plexopathy in cancer. Neurology 1985; 35: 8-15
34. Zimmermann M. Pathobiology of neuropathic pain. Eur J Pharmacol 2001; 429: 23-37
35. Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole RM. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 2001; 94: 149-58
36. Cherny NJ, Chang V, Frager G et al. Opioid pharmacotherapy in the management of cancer pain: a survey of strategies used by pain physicians for the selection of analgesic drugs and routes of administration. Cancer 1995; 76: 1283-93
37. Cherny NI, Portenoy RK. The management of cancer pain. CA Cancer J Clin 1994; 44: 263-303
38. Skaer TL. Practice guidelines for transdermal opioids in malignant pain. Drugs 2004; 64: 2629-38
39. Donnelly S, Davis MP, Walsh D, Naughton M. Morphine in cancer pain management: a practical guide. Support Care Cancer 2002; 10: 13-35
40. Walsh D. Advances in opioid therapy and formulations. Support Care Cancer 2005; 13: 138-44
41. Hwang SS, Chang VT, Kasimis B. Cancer breakthrough pain characteristics and responses to treatment at a VA medical center. Pain 2003; 101: 55-64
42. Portenoy RK, Hagen NA. Breakthrough pain: definition, prevalence and characteristics. Pain 1990; 41: 273-81
43. Caraceni A, Martini C, Zecca E et al. Breakthrough pain characteristics and syndromes in patients with cancer pain. An international survey. Palliat Med 2004; 18: 177-83
44. Portenoy RK, Foley KM, Inturrisi CE. The nature of opioid responsiveness and its implications for neuropathic pain: new hypotheses derived from studies of opioid infusions. Pain 1990; 43: 273-86
45. Mercadante S, Portenoy RK. Opioid poorly-responsive cancer pain. Part 3. Clinical strategies to improve opioid responsiveness. J Pain Symptom Manage 2001; 21: 338-54
46. Mercadante S, Portenoy RK. Opioid poorly-responsive cancer pain. Part 2: basic mechanisms that could shift dose-response for analgesia. J Pain Symptom Manage 2001; 21: 255-64
47. Mercadante S, Portenoy RK. Opioid poorly-responsive cancer pain. Part 1: clinical considerations. J Pain Symptom Manage 2001; 21: 144-50
48. Cherny NI, Thaler HT, Friedlander-Klar H et al. Opioid responsiveness of cancer pain syndromes caused by neuropathic or nociceptive mechanisms: a combined analysis of controlled, single-dose studies. Neurology 1994; 44: 857-61
49. McDonald AA, Portenoy RK. How to use antidepressants and anticonvulsants as adjuvant analgesics in the treatment of neuropathic cancer pain. J Support Oncol 2006; 4: 43-52
50. Wilder-Smith CH, Schimke J, Osterwalder B, Senn HJ. Oral tramadol, a μ-opioid agonist and monoamine reuptake-blocker, and morphine for strong cancer-related pain. Ann Oncol 1994; 5: 141-6
51. Leppert W, Luczak J. The role of tramadol in cancer pain treatment - a review. Support Care Cancer 2005; 13: 5-17
52. Alimi D, Rubino C, Pichard-Leandri E, Fermand-Brule S, Dubreuil-Lemaire ML, Hill C. Analgesic effect of auricular acupuncture for cancer pain: a randomized, blinded, controlled trial. J Clin Oncol 2003; 21: 4120-6
53. Gilron I, Bailey JM, Tu D, Holden RR, Weaver DF, Houlden RL. Morphine, gabapentin, or their combination for neuropathic pain. New Engl J Med 2005; 352: 1324-34
54. Meier T, Wasner G, Faust M et al. Efficacy of lidocaine patch 5% in the treatment of focal peripheral neuropathic pain syndromes: a randomized, double-blind, placebocontrolled study. Pain 2003; 106: 151-8
55. O'Connell CL, Boswell WD, Duddalwar V et al. Unsuspected pulmonary emboli in cancer patients: clinical correlates and relevance. J Clin Oncol 2006; 24: 4928-32
56. White RH, Chew HK, Zhou H et al. Incidence of venous thromboembolism in the year before the diagnosis of cancer in 528,693 adults. Arch Intern Med 2005; 165: 1782-7
57. Lee AY, Levine MN, Baker RI et al. Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med 2003; 349: 146-53
58. Piazza G, Goldhaber SZ. Acute pulmonary embolism: part II: treatment and prophylaxis. Circulation 2006; 114: e42-7
59. Cunningham RS. The role of low-molecular-weight heparins as supportive care therapy in cancer-associated thrombosis. Semin Oncol 2006; 33 (Suppl. 4): S17-25
60. Buchner A, Riesenberg R, Kotter I, Hofstetter A, Stief C, Oberneder R. Frequency and prognostic relevance of disseminated tumor cells in bone marrow of patients with metastatic renal cell carcinoma. Cancer 2006; 106: 1514-20
61. Tannir N, Jonasch E, Pagliaro LC et al. Pilot trial of bone-targeted therapy with zoledronate, thalidomide, and interferon-γ for metastatic renal cell carcinoma. Cancer 2006; 107: 497-505
62. Leibovich BC, Cheville JC, Lohse CM et al. A scoring algorithm to predict survival for patients with metastatic clear cell renal cell carcinoma: a stratification tool for prospective clinical trials. J Urol 2005; 174: 1759-63
63. Han KR, Pantuck AJ, Bui MH et al. Number of metastatic sites rather than location dictates overall survival of patients with node-negative metastatic renal cell carcinoma. Urology 2003; 61: 314-9
64. Negrier S, Escudier B, Gomez F et al. Prognostic factors of survival and rapid progression in 782 patients with metastatic renal carcinomas treated by cytokines: a report from the Groupe Francais d'Immunotherapie. Ann Oncol 2002; 13: 1460-8
65. Schoder H, Larson SM. Positron emission tomography for prostate, bladder, and renal cancer. Semin Nucl Med 2004; 34: 274-92
66. Adiga GU, Dutcher JP, Larkin M, Garl S, Koo J. Characterization of bone metastases in patients with renal cell cancer. BJU Int 2004; 93: 1237-40
67. Liu PT, Conley CR, Callstrom MR. Sclerotic bone metastases from sarcomatoid renal cell carcinoma. Skeletal Radiol 1999; 28 : 590-3
68. Cangiano T, Liao J, Naitoh J, Dorey F, Figlin R, Belldegrun A. Sarcomatoid renal cell carcinoma: biologic behavior, prognosis, and response to combined surgical resection and immunotherapy. J Clin Oncol 1999; 17: 523-8
69. Shvarts O, Lam JS, Kim HL, Han KR, Figlin R, Belldegrun A. Eastern Cooperative Oncology Group performance status predicts bone metastasis in patients presenting with renal cell carcinoma: implication for preoperative bone scans. J Urol 2004; 172: 867-70
70. DiBiase SJ, Valicenti RK, Schultz D, Xie Y, Gomella LG, Corn BW. Palliative irradiation for focally symptomatic metastatic renal cell carcinoma: support for dose escalation based on a biological model. J Urol 1997; 158: 746-9
71. Smith EM, Kursh ED, Makley J, Resnick MI. Treatment of osseous metastases secondary to renal cell carcinoma. J Urol 1992; 148: 784-7
72. Ahlmann ER, Menendez LR, Kermani C, Gotha H. Survivorship and clinical outcome of modular endoprosthetic reconstruction for neoplastic disease of the lower limb. J Bone Joint Surg Br 2006; 88: 790-5
73. Menendez LR, Tan MS, Kiyabu MT, Chawla SP. Cryosurgical ablation of soft tissue sarcomas: a phase I trial of feasibility and safety. Cancer 1999; 86: 50-7
74. Warzelhan J, Stoelben E, Imdahl A, Hasse J. Results in surgery for primary and metastatic chest wall tumors. Eur J Cardiothorac Surg 2001; 19: 584-8
75. Sundaresan N, Rothman A, Manhart K, Kelliher K. Surgery for solitary metastases of the spine: rationale and results of treatment. Spine 2002; 27: 1802-6
76. Patchell RA, Tibbs PA, Regine WF et al. Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet 2005; 366: 643-8
77. O'Reilly GV, Kleefield J, Klein LA, Blume HW, Dubuisson D, Cosgrove GR. Embolization of solitary spinal metastases from renal cell carcinoma: alternative therapy for spinal cord or nerve root compression. Surg Neurol 1989; 31: 268-71
78. Gerszten PC, Burton SA, Ozhasoglu C et al. Stereotactic radiosurgery for spinal metastases from renal cell carcinoma. J Neurosurg Spine 2005; 3: 288-95
79. Lipton A, Colombo-Berra A, Bukowski RM, Rosen L, Zheng M, Urbanowitz G. Skeletal complications in patients with bone metastases from renal cell carcinoma and therapeutic benefits of zoledronic acid. Clin Cancer Res 2004; 10: 6397S-403S
80. Lipton A, Zheng M, Seaman J. Zoledronic acid delays the onset of skeletal-related events and progression of skeletal disease in patients with advanced renal cell carcinoma. Cancer 2003; 98: 962-9
81. Ibrahim A, Scher N, Williams G et al. Approval summary for zoledronic acid for treatment of multiple myeloma and cancer bone metastases. Clin Cancer Res 2003; 9: 2394-9
82. Saad F, Lipton A. Zoledronic acid is effective in preventing and delaying skeletal events in patients with bone metastases secondary to genitourinary cancers. BJU Int 2005; 96: 964-9
83. Mignogna MD, Fedele S, Lo Russo L, Ciccarelli R, Lo Muzio L. Case 2. Osteonecrosis of the jaws associated with bisphosphonate therapy. J Clin Oncol 2006; 24: 1475-7
84. Motzer RJ, Michaelson MD, Redman BG et al. Activity of SU11248, a multitargeted inhibitor of vascular endothelial growth factor receptor and platelet-derived growth factor receptor, in patients with metastatic renal cell carcinoma. J Clin Oncol 2006; 24: 16-24
85. Ratain MJ, Eisen T, Stadler WM et al. Phase II placebo-controlled randomized discontinuation trial of sorafenib in patients with metastatic renal cell carcinoma. J Clin Oncol 2006; 24: 2505-12
86. Culine S, Bekradda M, Kramar A, Rey A, Escudier B, Droz JP. Prognostic factors for survival in patients with brain metastases from renal cell carcinoma. Cancer 1998; 83: 2548-53
87. Petrovich Z, Yu C, Giannotta SL, O'Day S, Apuzzo ML. Survival and pattern of failure in brain metastasis treated with stereotactic γ?knife radiosurgery. J Neurosurg 2002; 97 (Suppl.): 499-506
88. Cannady SB, Cavanaugh KA, Lee SY et al. Results of whole brain radiotherapy and recursive partitioning analysis in patients with brain metastases from renal cell carcinoma: a retrospective study. Int J Radiat Oncol Biol Phys 2004; 58: 253-8
89. Motzer RJ, Bacik J, Schwartz LH et al. Prognostic factors for survival in previously treated patients with metastatic renal cell carcinoma. J Clin Oncol 2004; 22: 454-63
90. Hurst R, White DE, Heiss J, Lee DS, Rosenberg SA, Schwartzentruber DJ. Brain metastasis after immunotherapy in patients with metastatic melanoma or renal cell cancer: is craniotomy indicated? J Immunother 1999; 22: 356-62
91. Chang EL, Selek U, Hassenbusch SJ et al. Outcome variation among 'radioresistant' brain metastases treated with stereotactic radiosurgery. Neurosurgery 2005; 56: 936-45
92. Jain SK, Dupuy DE, Cardarelli GA, Zheng Z, DiPetrillo TA. Percutaneous radiofrequency ablation of pulmonary malignancies: combined treatment with brachytherapy. AJR Am J Roentgenol 2003; 181: 711-5
93. Huland E, Huland H, Heinzer H. Interleukin-2 by inhalation: local therapy for metastatic renal cell carcinoma. J Urol 1992; 147: 344-8
94. Lorenz J, Wilhelm K, Kessler M et al. Phase I trial of inhaled natural interleukin 2 for treatment of pulmonary malignancy: toxicity, pharmacokinetics, and biological effects. Clin Cancer Res 1996; 2: 1115-22
95. Merimsky O, Gez E, Weitzen R et al. Targeting pulmonary metastases of renal cell carcinoma by inhalation of interleukin-2. Ann Oncol 2004; 15: 610-2
96. Atzpodien J, Kirchner H, Rebmann U et al. Interleukin-2/interferon-α2a/13-retinoic acid-based chemoimmunotherapy in advanced renal cell carcinoma: results of a prospectively randomised trial of the German Cooperative Renal Carcinoma Chemoimmunotherapy Group (DGCIN). Br J Cancer 2006; 95: 463-9
97. Huland E, Heinzer H, Huland H, Yung R. Overview of interleukin-2 inhalation therapy. Cancer J Sci Am 2000; 6 (Suppl. 1): S104-12
98. Heinzer H, Mir TS, Huland E, Huland H. Subjective and objective prospective, long-term analysis of quality of life during inhaled interleukin-2 immunotherapy. J Clin Oncol 1999; 17: 3612-20
99. Parlow JL, Milne B, Tod DA, Stewart GI, Griffiths JM, Dudgeon DJ. Self-administered nitrous oxide for the management of incident pain in terminally ill patients: a blinded case series. Palliat Med 2005; 19: 3-8
100. Coyne PJ, Viswanathan R, Smith TJ. Nebulized fentanyl citrate improves patients' perception of breathing, respiratory rate, and oxygen saturation in dyspnea. J Pain Symptom Manage 2002; 23: 157-60
101. Matsuzaki A, Suminoe A, Koga Y, Kinukawa N, Kusuhara K, Hara T. Immune response after influenza vaccination in children with cancer. Pediatr Blood Cancer 2005; 45: 831-7
102. Earle CC. Influenza vaccination in elderly patients with advanced colorectal cancer. J Clin Oncol 2003; 21: 1161-6
103. Nordoy T, Aaberge IS, Husebekk A et al. Cancer patients undergoing chemotherapy show adequate serological response to vaccinations against influenza virus and Streptococcus pneumoniae. Med Oncol 2002; 19: 71-8
104. Chisholm JC, Devine T, Charlett A, Pinkerton CR, Zambon M. Response to influenza immunisation during treatment for cancer. Arch Dis Child 2001; 84: 496-500
105. Steinherz PG, Brown AE, Gross PA et al. Influenza immunization of children with neoplastic diseases. Cancer 1980; 45: 750-6
106. Hayney MS, Welter DL, Francois M, Reynolds AM, Love RB. Influenza vaccine antibody responses in lung transplant recipients. Prog Transplant 2004; 14: 346-51