Graft-versus-host disease is the major determinant of humoral responses to the AS03-adjuvanted influenza A/09/H1N1 vaccine in allogeneic hematopoietic stem cell transplant recipients
| Autor: | Mohty Bilal, Bel Michael, Vukicevic Marija, Nagy Monika, Levrat Emmanuel, Meier Sara, Grillet Stephane, Combescure Christophe, Kaiser Laurent, Chalandon Yves, Passweg Jakob, Siegrist Claire-Anne, Roosnek Eddy, Blood and Marrow Transplant Program, Geneva University Hospitals H1N1 study group |
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| Přispěvatelé: | Mohty, Bilal, Bel, Michael, Vukicevic Verhille, Marija, Nagy, Monika, Levrat, Emmanuel, Meier, Sara, Grillet, Stéphane, Combescure, Christophe, Kaiser, Laurent, Chalandon, Yves, Passweg, Jakob, Siegrist, Claire-Anne, Roosnek, Eddy Emile, Posfay Barbe, Klara, Sealy, Gregg, Charvat-Jackson, Sandrine, Desmeules, Jules Alexandre, Verdon, Mélanie, Hirschel, Bernard, Calmy, Alexandra, Nguyen, Alexandra, Delhumeau-Cartier, Cécile, Ambrosini, Joëlle, Gabay, Cem, Guerne, Pierre-André, Seebach, Jorg Dieter, Ribi, Camillo, Villard, Jean, Dietrich, Pierre-Yves, George, Anne-Claude Catherine, Favet, Laurence, Van Delden, Christian, Morard, Isabelle, Mentha, Gilles, Giostra, Emiliano, Hadaya, Karine, Martin, Pierre-Yves, Gasche-Soccal, Paola Marina Alessandra, Berney, Thierry, Noble, Stéphane Laurent, Yerly Ferrillo, Sabine, Thomas, Yves, Wunderli, Werner |
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Male
Antibody Formation/immunology medicine.medical_treatment Graft vs Host Disease Hematopoietic stem cell transplantation ddc:616.07 Antibodies Viral 0302 clinical medicine Medicine ddc:616 ddc:618 ddc:617 Hematopoietic Stem Cell Transplantation virus diseases Hematology Middle Aged 3. Good health Vaccination Influenza Vaccines/adverse effects/immunology Influenza Vaccines 030220 oncology & carcinogenesis Female Graft vs Host Disease/immunology Stem cell Adult 03 medical and health sciences Immunocompromised Host Transplantation Homologous/immunology Young Adult Immune system Immunity Transplantation Homologous Humans AS03 Hematopoietic Stem Cell Transplantation/adverse effects Aged Antibodies Viral/blood/immunology Immunity Humoral/immunology business.industry Original Articles medicine.disease Virology Immunity Humoral Transplantation Graft-versus-host disease Immunology Antibody Formation Immunization business 030215 immunology |
| Zdroj: | Haematologica, Vol. 96, No 6 (2011) pp. 896-904 Haematologica |
| ISSN: | 0390-6078 |
| Popis: | BACKGROUND Responses to influenza vaccines are poorly characterized in immunocompromised patients. The goal of this study was to assess the efficacy of the AS03 adjuvanted influenza H1N1/A/09 vaccine in allogeneic hematopoietic stem cell transplant recipients. DESIGN AND METHODS We enrolled 65 patients and 138 controls in an open prospective study. Controls received one dose and patients 2 doses of the AS03 adjuvanted influenza H1N1/A/09 vaccine at a 3 week interval. Geometric mean titers and seroprotection/seroconversion rates were determined by hemagglutination inhibition before and four weeks after the last immunization. Clinical and biological markers including immunoglobulins CD3+ CD4+ CD8+ and naïve CD4+ T cell counts were assessed in all patients. RESULTS Baseline seroprotection rates were low in patients (6.6) and controls (14.8). After 2 doses patients (n=57 92.3) achieved similar seroprotection rates (84 vs. 87 P=0.65) and antibody titers (305 vs. 340 P=0.88) as controls (n=131 93.9) after one dose. In univariate analysis transplant to vaccination interval less than 12 months active graft versus host disease immunosuppressive drugs hemoglobin less than 12 g/L lymphopenia less than 1 G/L IgG less than 4 g/L IgA less than 0.5 g/L IgM less than 0.5 g/L and naive CD4+ T cells less than 150/µL were significantly associated with weaker responses. Multivariate analysis identified transplant to vaccination interval and active graft versus host disease as the most powerful negative predictors of antibody responses (P=0.04 and P=0.002 respectively). Vaccination was well tolerated in both cohorts. CONCLUSIONS In allogeneic hematopoietic stem cell transplant recipients 2 doses of an adjuvanted influenza vaccine elicited comparable responses to a single dose in healthy individuals. However vaccine responses remained poor in patients with ongoing graft versus host disease supporting the need for additional strategies in this high risk patient population. (ClinicalTrials.gov Identifier: NCT01022905). |
| Databáze: | OpenAIRE |
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