Longitudinal analysis of antibody response to immunization in paediatric survivors after allogeneic haematopoietic stem cell transplantation

被引:39
作者
Inaba, Hiroto [2 ,3 ]
Hartford, Christine M.
Pei, Deqing [4 ]
Posner, Meredith J. [2 ]
Yang, Jie [4 ]
Hayden, Randall T. [5 ]
Srinivasan, Ashok [1 ,3 ]
Triplett, Brandon M. [1 ,3 ]
McCulllers, Jon A. [3 ,6 ]
Pui, Ching-Hon [2 ,3 ]
Leung, Wing [1 ,3 ]
机构
[1] St Jude Childrens Res Hosp, Dept Bone Marrow Transplantat & Cellular Therapy, Memphis, TN 38105 USA
[2] St Jude Childrens Res Hosp, Dept Oncol, Memphis, TN 38105 USA
[3] Univ Tennessee, Hlth Sci Ctr, Dept Paediat, Knoxville, TN 37996 USA
[4] St Jude Childrens Res Hosp, Dept Biostat, Memphis, TN 38105 USA
[5] St Jude Childrens Res Hosp, Dept Pathol, Memphis, TN 38105 USA
[6] St Jude Childrens Res Hosp, Dept Infect Dis, Memphis, TN 38105 USA
基金
美国国家卫生研究院;
关键词
childhood; haematopoietic stem cell transplantation; allogeneic; immunization; survivor; BONE-MARROW-TRANSPLANTATION; HEPATITIS-B-VACCINE; INFLUENZAE TYPE-B; IMMUNE RECONSTITUTION; INFECTIOUS COMPLICATIONS; DIPHTHERIA TOXOIDS; RECIPIENTS; CHILDREN; TETANUS; IMMUNOGENICITY;
D O I
10.1111/j.1365-2141.2011.08913.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The long-term antibody responses to re-immunization in recipients of allogeneic haematopoietic stem cell transplantation (allo-HSCT) have not been well studied. We prospectively and longitudinally evaluated the antibody responses to eight vaccine antigens (diphtheria, tetanus, pertussis, measles, mumps, rubella, hepatitis B, and poliovirus) and assessed the factors associated with negative titres in 210 allo-HSCT recipients at St. Jude Childrens Research Hospital. Antibody responses lasting for more than 5 years after immunization were observed in most patients for tetanus (95.7%), rubella (92.3%), poliovirus (97.9%), and, in diphtheria-tetanus-acellular pertussis (DTaP) recipients, diphtheria (100%). However, responses to pertussis (25.0%), measles (66.7%), mumps (61.5%), hepatitis B (72.9%), and diphtheria in tetanus-diphtheria (Td) recipients (48.6%) were less favourable, with either only transient antibody responses or persistently negative titres. Factors associated with vaccine failure were older age at immunization; lower CD3, CD4 or CD19 counts; higher IgM concentrations; positive recipient cytomegalovirus serology; negative titres before immunization; acute or chronic graft-versus-host disease; and radiation during preconditioning. These response patterns and clinical factors can be used to formulate re-immunization and monitoring strategies. Patients at risk for vaccine failure should have long-term follow-up; those with loss of antibody response or no seroconversion should receive booster immunizations.
引用
收藏
页码:109 / 117
页数:9
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