Predictive factors for vaccine failure to guide vaccination in allogeneic hematopoietic stem cell transplant recipients.

Autor: Janssen MJM; Department of Infectious Diseases, UMC Utrecht, Utrecht, the Netherlands. mjm_janssen@hotmail.com., Bruns AHW; Department of Infectious Diseases, UMC Utrecht, Utrecht, the Netherlands., Verduyn Lunel FM; Department of Microbiology, UMC Utrecht, Utrecht, the Netherlands., Raijmakers RAP; Department of Hematology, UMC Utrecht, Utrecht, the Netherlands., de Weijer RJ; Department of Hematology, UMC Utrecht, Utrecht, the Netherlands., Nanlohy NM; Center for Infectious Disease Control, RIVM, Bilthoven, the Netherlands., Smits GP; Center for Infectious Disease Control, RIVM, Bilthoven, the Netherlands., van Baarle D; Center for Infectious Disease Control, RIVM, Bilthoven, the Netherlands.; Center for Translational Immunology, UMC Utrecht, Utrecht, the Netherlands., Kuball J; Department of Hematology, UMC Utrecht, Utrecht, the Netherlands.
Jazyk: angličtina
Zdroj: Bone marrow transplantation [Bone Marrow Transplant] 2021 Dec; Vol. 56 (12), pp. 2922-2928. Date of Electronic Publication: 2021 Aug 20.
DOI: 10.1038/s41409-021-01437-0
Abstrakt: Vaccination after hematopoietic stem cell transplantation (HSCT) is essential to protect high-risk patients against potentially lethal infections. Though multiple studies have evaluated vaccine specific responses, no comprehensive analysis of a complete vaccination schedule post-HSCT has been performed and little is known about predictors for vaccine failure. In this context, allogeneic HSCT (alloHSCT) patients were included and vaccinated starting one year post-transplantation. Antibody responses were measured by Multiplex Immuno Assay for pneumococcal (PCV13), meningococcal C, diphtheria, pertussis, tetanus and Haemophilus influenza type b one month after the last vaccination and correlated to clinical and immunological parameters. Vaccine failure was defined as antibody response above vaccine-specific cut-off values for less than four out of six vaccines. Ninety-six patients were included of which 27.1% was found to have vaccine failure. Only 40.6% of all patients responded adequately to all six vaccines. In multivariate analysis, viral reactivation post-HSCT (OR 6.53; P = 0.03), B-cells <135 per mm 3 (OR 7.24; P = 0.00) and NK-cells <170 per mm 3 (OR 11.06; P = 0.00) were identified as predictors for vaccine failure for vaccination at one year post-alloHSCT. Measurement of antibody responses and an individualized approach for revaccination guided by clinical status and immune reconstitution of B-cells and NK-cells may improve vaccine responses.
(© 2021. The Author(s), under exclusive licence to Springer Nature Limited.)
Databáze: MEDLINE
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