An Immune Recovery-Based Revaccination Protocol for Pediatric Hematopoietic Stem Cell Transplant Recipients: Revaccination Outcomes Following Pediatric HSCT

Haynes, Andrew S; Curtis, Donna; Campbell, Kristen; Giller, Roger; Quinones, Ralph; Verneris, Michael R.; Abzug, Mark J.

doi:10.1016/j.jtct.2021.01.017

Cited by 12 publications

(13 citation statements)

References 33 publications

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“…The best demonstration of complete restoration of the adaptive immune system after HCT is response to vaccination with specific antibody production. It has been demonstrated that revaccination based on acquisition of immune milestones is associated with higher rates of vaccine mediated immunity [15,16]. However, most current recommendations are to initiate revaccination post-transplant based on time rather than acquisition of immune milestones, [17À19] and response to vaccination is not uniformly assessed.…”

Section: Milestones Of Immune Reconstitutionmentioning

confidence: 99%

“…Other identified factors predictive of a poor response included being on immune suppression [21,22] and lymphopenia [22]. Short of response to vaccination, other milestones of immune reconstitution evaluated at least 6 months after HCT have been demonstrated to be associated with both response to vaccination and improved overall survival, [15,[23][24][25] but have not been assessed prospectively as primary outcomes. Other investigators have evaluated immune reconstitution as a continuous variable [24,26].…”

Section: Milestones Of Immune Reconstitutionmentioning

confidence: 99%

See 1 more Smart Citation

An ISCT Stem Cell Engineering Committee Position Statement on Immune Reconstitution: the importance of predictable and modifiable milestones of immune reconstitution to transplant outcomes

et al. 2022

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Section: Milestones Of Immune Reconstitutionmentioning

confidence: 99%

Section: Milestones Of Immune Reconstitutionmentioning

confidence: 99%

An ISCT Stem Cell Engineering Committee Position Statement on Immune Reconstitution: the importance of predictable and modifiable milestones of immune reconstitution to transplant outcomes

et al. 2022

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“…83 More recent published consensus guidelines 12,14,80,84,85 recommend starting recipient vaccination with nonreplicating vaccines at 3-6 months post-HSCT (using minimal recommended dosing intervals if feasible), though TA B L E 2 Minimum criteria to suggest immune reconstitution post-HSCT. 13,76,80,86 enrolled in an immune recovery-based protocol that prescribes a minimum time interval and immunologic and treatment benchmarks to be met before vaccination. 86 As of 2017, patients were eligible to start inactivated/nonreplicating vaccines as early as 100 days post-HSCT if they are off systemic immunosuppression, off IVIg >3 months, have no active GVHD, achieve a CD4 count > 400 cells/µL for allogenic HSCT (200 cells/µL if autologous), and achieve an ALC count > 1000 cells/µL.…”

Section: Vaccinations In Children Receiving Hematopoietic Stem Cell T...mentioning

confidence: 99%

Vaccinations in children with hematologic malignancies and those receiving hematopoietic stem cell transplants or cellular therapies

Neemann

Sato

2023

Transplant Infectious Dis

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Children who are immune compromised are uniquely threatened by a higher risk of infections, including vaccine‐preventable diseases (VPDs). Children who undergo chemotherapy or cellular therapies may not have preexisting immunity to VPDs at the time of their treatment including not yet receiving their primary vaccine series, and additionally they have higher risk of exposures (e.g., due to family structures, daycare and school setting) with decreased capacity to protect themselves using nonpharmaceutic measures (e.g., masking). In the past, efforts to revaccinate these children have often been delayed or incomplete. Treatment with chemotherapy, stem cell transplants, and/or cellular therapies impair the ability of the immune system to mount a robust vaccine response. Ideally, protection would be provided as soon as both safe and effective, which will vary by vaccine type (e.g., replicating versus nonreplicating; conjugated versus polysaccharide). While a single approach revaccination schedule following these therapies would be convenient for providers, it would not account for patient specific factors that influence the timing of immune reconstitution (IR). Evidence suggests that many of these children would mount a meaningful vaccine response as early as 3 months following completion of treatment. Here within, we provide updated guidance on how to approach vaccination both during and following completion of these therapies.

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“…However, data on vaccination schedule adherence and compliance with the guidelines are lacking in this context. Assessments of vaccination practices are needed to overcome these limitations 8–12. Therefore, this study aimed to evaluate the compliance of allogeneic HSCT recipient children to the revaccination program and assess the humoral immunity status after vaccination.…”

mentioning

confidence: 99%

“…Assessments of vaccination practices are needed to overcome these limitations. [8][9][10][11][12] Therefore, this study aimed to evaluate the compliance of allogeneic HSCT recipient children to the revaccination program and assess the humoral immunity status after vaccination.…”

mentioning

confidence: 99%

Vaccine Adherence and Postvaccination Serological Status of Pediatric Allogeneic Hematopoietic Stem Cell Transplant Recipients: A Single-center Experience

Aşkan

Özden

Tezcan

et al. 2022

Journal of Pediatric Hematology/Oncology

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Despite developing consensus guidelines addressing immunization after hematopoietic stem cell transplantation (HSCT), studies showed deviations from recommended immunization practices commonly occur. Difference between the ideal scenario presented in guidelines and real-life scenarios is one of the most recognized barriers to implementing recommended practices. Therefore, this study aimed to evaluate pediatric allogeneic HSCT recipients’ adherence to revaccination schedule and evaluate the serological status after immunization. Transplant and vaccination records of children who were followed up at least 2 years after HSCT, postvaccination antibody results of vaccine-preventable diseases were evaluated retrospectively. Total of 173 patients have enrolled in this study. Median revaccination onset time was post-transplant 15 months. Adherence to revaccination program was 30% for inactive and 11.4% for live vaccines. Oral polio vaccine was given to 22 patients, and Bacille-Calmette-Guerin vaccine was applied to 3. Seropositivity after revaccination was >90% for Hepatitis B, Hepatitis A, pertussis, and measles, and it was 88.5% for rubella, 80% for mumps and varicella. Measles seropositivity was low in children with hemoglobinopathy. In subgroup assessments of pertussis, patients vaccinated with low antigen-containing pertussis vaccine (Tdap) had higher seropositivity of adenylate cyclase toxin. Our findings revealed the importance of careful monitoring of current practices in pediatric HSCT recipients.

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An Immune Recovery-Based Revaccination Protocol for Pediatric Hematopoietic Stem Cell Transplant Recipients: Revaccination Outcomes Following Pediatric HSCT

Cited by 12 publications

References 33 publications

An ISCT Stem Cell Engineering Committee Position Statement on Immune Reconstitution: the importance of predictable and modifiable milestones of immune reconstitution to transplant outcomes

An ISCT Stem Cell Engineering Committee Position Statement on Immune Reconstitution: the importance of predictable and modifiable milestones of immune reconstitution to transplant outcomes

Vaccinations in children with hematologic malignancies and those receiving hematopoietic stem cell transplants or cellular therapies

Vaccine Adherence and Postvaccination Serological Status of Pediatric Allogeneic Hematopoietic Stem Cell Transplant Recipients: A Single-center Experience

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