A National Survey of Immunization Practices Following Allogeneic Bone Marrow Transplantation

Henning, Kelly J.; White, Mary H.; Sepkowitz, Kent A.; Armstrong, Donald

doi:10.1001/jama.1997.03540380062032

Cited by 57 publications

(36 citation statements)

References 19 publications

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“…12,14 A survey of reimmunization protocols in Europe found wide variations in practice. 12 Tetanus toxoid vaccination was the most common practice, with 65% of the surveyed centers administering this to allograft recipients, and 37% to autograft recipients.…”

Section: Current Practicementioning

confidence: 99%

“…On the other hand, pertussis vaccination was the least common practice, with only one center using this. 12 A survey of 45 North American transplant centers affiliated with the National Marrow Donor Program 14 showed that 97% of centers allografting patients under the age of 7 years and 88% of those allografting patients aged 7 years or older gave either the DPT or the DT vaccine, whereas 77% and 58%, respectively, used the Hib conjugate vaccine. Inactivated poliovirus and MMR vaccines were given by 94% and 94% of the centers, respectively, to patients younger than 7, and by 73% and 70%, respectively, to the older age group.…”

Section: Current Practicementioning

confidence: 99%

“…Few centers reported using multiple doses, and the number of different schedules reported for specific vaccines varied widely. 14 …”

Section: Current Practicementioning

confidence: 99%

“…[9][10][11] Because of these reasons, it is essential to reimmunize peripheral blood stem cell (PBSCT) or bone marrow transplant (BMT) recipients at appropriate times following transplantation. [12][13][14] …”

mentioning

confidence: 99%

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Reimmunization after blood or marrow stem cell transplantation

Singhal

Mehta

1999

Bone Marrow Transplant

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Summary:Protective immunity to diseases preventable by routine vaccination is lost over time following allogeneic and autologous blood and marrow transplantation. Adoptive transfer of immunity from donors to recipients after allogeneic transplantation is not sufficient to prevent this decline. Systematic reimmunization is necessary at appropriate time intervals following transplantation to re-establish immunity. Response to vaccination depends upon the type of transplant, the source of cells, the immune status of the patient, and the vaccine being used. While inactivated or subunit vaccines are safe in all transplant recipients, live vaccines are generally contraindicated. Reimmunization practices vary widely amongst transplant centers. This comprehensive review summarizes published data on post-transplant vaccination, and based upon these, suggests guidelines which may be used as a framework for development of reimmunization protocols. Keywords: allogeneic bone marrow transplantation; autologous bone marrow transplantation; hematopoietic stem cell transplantation; immunization; vaccination Passive immunization consists of the administration of antibody-containing immunoglobulin preparations to provide temporary protection. Active immunization refers to the administration of a vaccine or a toxoid and is analogous to vaccination. 1 Vaccines available for routine use in children include diphtheria-pertussis-tetanus (DPT), trivalent polio, measles-mumps-rubella (MMR), Haemophilus influenzae type b (Hib), hepatitis B and tuberculosis (BCG). Adult vaccines include diphtheria-tetanus (DT), hepatitis B, influenza virus and pneumococcus. The use of meningococcal, hepatitis A and varicella vaccines is increasing. A number of other vaccines are also available for special circumstances. 1 Most allogeneic and a large proportion of autologous bone marrow transplant recipients lose their immunity to poliovirus, tetanus, diphtheria and measles after transplantation. 2 risk of developing infections with organisms such as H. influenzae and Streptococcus pneumoniae for which vaccines are available. 9-11 Because of these reasons, it is essential to reimmunize peripheral blood stem cell (PBSCT) or bone marrow transplant (BMT) recipients at appropriate times following transplantation. 12-14 Current practiceSystematic post-transplant reimmunization is a relatively neglected area. 12,14 A survey of reimmunization protocols in Europe found wide variations in practice. 12 Tetanus toxoid vaccination was the most common practice, with 65% of the surveyed centers administering this to allograft recipients, and 37% to autograft recipients. On the other hand, pertussis vaccination was the least common practice, with only one center using this. 12 A survey of 45 North American transplant centers affiliated with the National Marrow Donor Program 14 showed that 97% of centers allografting patients under the age of 7 years and 88% of those allografting patients aged 7 years or older gave either the DPT or the DT vaccine, whereas 77% and 58%, res...

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Section: Current Practicementioning

confidence: 99%

Section: Current Practicementioning

confidence: 99%

“…Few centers reported using multiple doses, and the number of different schedules reported for specific vaccines varied widely. 14 …”

Section: Current Practicementioning

confidence: 99%

mentioning

confidence: 99%

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Reimmunization after blood or marrow stem cell transplantation

Singhal

Mehta

1999

Bone Marrow Transplant

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“…Several surveys regarding reimmunization after BMT have demonstrated that vaccination protocols vary greatly among BMT centers, with insufficient data to establish solid recommendations (6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Reimmunization after bone marrow transplantation: current recommendations and perspectives

Machado

2004

Braz J Med Biol Res

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Autologous and allogeneic bone marrow transplantation (BMT) recipients lose immune memory of exposure to infectious agents and vaccines accumulated through a lifetime and therefore need to be revaccinated. Diphtheria toxoid, tetanus toxoid, pertussis vaccine (children <7 years old), Haemophilus influenzae type b conjugate, 23-valent pneumococcal polysaccharide, inactivated influenza vaccine, inactivated polio vaccine and live-attenuated measles-mumps-rubella vaccine are the currently recommended vaccines to be included in a vaccination program after BMT. For most of them, the best time to vaccinate, the number of vaccine doses and/or the duration of immunity after vaccination have not been established. Vaccination protocols vary greatly among BMT centers, suggesting that the lack of sufficient data has not permitted the formulation of reliable recommendations. The use of other vaccines and the perspectives for different vaccination protocols are analyzed in this review.

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