Sattler, Clara and Hoffmann, Petra and Herzberg, Philipp Yorck and Weber, Daniela and Holler, Barbara and Fehn, Ute and Plentz, Annelie and Beckhove, Philipp and Winkler, Julia and Edinger, Matthias and Herr, Wolfgang and Holler, Ernst and Wolff, Daniel (2021) Primary vaccination in adult patients after allogeneic hematopoietic stem cell transplantation-A single center retrospective efficacy analysis. VACCINE, 39 (33). pp. 4742-4750. ISSN 0264-410X, 1873-2518
Full text not available from this repository. (Request a copy)Abstract
Allogeneic hematopoietic stem cell transplantation (alloHSCT) results in a loss of humoral immunity and subsequent risk for severe infections. Thus, re-vaccination is required but may fail due to incomplete immune reconstitution. We retrospectively analyzed predictors of immune response to primary vaccina-tion applied according to the EBMT (European Blood and Marrow Transplantation Group) recommenda-tions. Serologic response to vaccination against diphtheria (D), tetanus (T), Bordetella pertussis (aP) and Haemophilus influenzae (Hib) (administrated as combined DTaP-Hib-IPV vaccination) was studied in 84 alloHSCT patients transplanted between 2008 and 2015 (age at alloHSCT: 18.6-70.6 years). All patients with a relapse-free survival of >9 months, at least 3 consecutive vaccinations and absence of intravenous immunoglobulin administration within 3 months before and after vaccination met the primary inclusion criteria. Additionally, immunological response to a pneumococcal conjugate vaccine was analyzed in a subgroup of 67 patients. Patients' characteristics at the time of first vaccination were recorded. Responses were measured as vaccine-specific antibody titers. Regarding DTaP-Hib-IPV vaccination, 89.3% (n = 75) of all patients achieved protective titers to at least 3 of the 4 vaccine components and were thus considered responders. 10.7% (n = 9) of the patients were classified as non-responders with positive immune response to less than 3 components. Highest response was observed for Hib (97.4%), tetanus (95.2%) and pneumococcal vaccination (83.6%) while only 68.3% responded to vaccination against Bordetella pertussis. Significant risk factors for failure of vaccination response included low B cell counts (p < 0.001; cut-off: 0.05 B cells/nl) and low IgG levels (p = 0.026; mean IgG of responders 816 mg/dl vs. 475 mg/dl of non-responders). Further, a trend was observed that prior cGvHD impairs vaccination response as 88.9% of the non-responders but only 54.7% of the responders had prior cGvHD (p = 0.073). The results demonstrate, that the currently proposed vaccination strategy leads to seropro-tection in the majority of alloHSCT patients. (c) 2021 Elsevier Ltd. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | VERSUS-HOST-DISEASE; LINKED IMMUNOSORBENT ASSAYS; IMMUNE RECONSTITUTION; MARROW-TRANSPLANTATION; B-CELLS; RECOVERY; VACCINES; TETANUS; LYMPHOPOIESIS; DEFICIENCY; Allogeneic hematopoietic stem cell; transplantation; Vaccination; Immune response; GvHD; B cell reconstitution |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) Medicine > Lehrstuhl für Medizinische Mikrobiologie und Hygiene Medicine > Zentren des Universitätsklinikums Regensburg > Regensburger Centrum für Interventionelle Immunologie (RCI) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 05 Sep 2022 07:17 |
| Last Modified: | 05 Sep 2022 07:17 |
| URI: | https://pred.uni-regensburg.de/id/eprint/46564 |
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