| Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | Vaccine | ||||
| Publisher: | Elsevier | ||||
| Place of Publication: | OXFORD | ||||
| Volume: | 39 | ||||
| Number of Issue or Book Chapter: | 33 | ||||
| Page Range: | pp. 4742-4750 | ||||
| Date: | 2021 | ||||
| Institutions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) Medicine > Lehrstuhl für Medizinische Mikrobiologie und Hygiene Leibniz Institute for Immunotherapy (LIT) | ||||
| Identification Number: |
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| 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 | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 55915 |
Web of ScienceAbstract
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) ...
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.
Metadata last modified: 29 Feb 2024 12:20
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