Antibody responses to vaccinations given within the first two years after transplant are similar between autologous peripheral blood stem cell and bone marrow transplant recipients

Abstract

Summary:As a consequence of the significantly larger inoculum of lymphoid cells present in peripheral blood stem cell (PBSC) harvests compared to bone marrow (BM), it is possible that autoPBSCT recipients may have an earlier and/or enhanced response to vaccines. Until data to confirm this become available, the European Blood and Marrow Transplantation Association (EBMT) recommend that all transplant recipients be immunized in the same way regardless of stem cell source. We performed a prospective study comparing serological responses to influenza, pneumococcal polysaccharide and tetanus toxoid vaccines between autoPBSCT with autoBMT recipients. Antibody responses in sibling HLA-matched allogeneic BMT (alloBMT) survivors were also evaluated. All vaccines were administered within the first 2 years after stem cell transplantation. Fifty patients were enrolled. The time of vaccination after transplant was similar between autoPBSCT (mean 11 months for each vaccine) and autoBMT recipients (mean 12 months except 13 months for tetanus toxoid) (P = NS). Serological responses were poor and no significant difference in response to any of the vaccines used was seen between the three transplant cohorts. We provide no evidence that current EBMT guidelines be modified. Large prospective vaccine studies are needed to address the issue more fully. Bone Marrow Transplantation (2001) 28, 775-781.

Vaccination of stem cell transplant recipients: recommendations of the Infectious Diseases Working Party of the EBMT

“…Despite these differences, the risks of losing immunity to several infectious agents are similar after allogeneic and autologous SCT. The results of vaccination studies are also rather similar, [4][5][6][7][8][9] although there are a few reports showing that the type of transplant makes a difference to the results. 10 We have, however, chosen not to give different sets of recommendations for the different types of transplants, since using similar vaccination schedules for all transplant recipients is of practical importance for the work of transplant centers.…”

Significant and persistent loss of bone mineral density in the femoral neck after haematopoietic stem cell transplantation: long‐term follow‐up of a prospective study

“…Induction chemotherapy regimens used in the unit were as previously outlined (Gandhi et al, 1999a). Transplantation procedures were performed as per previously published protocols (Gandhi et al, 1999b(Gandhi et al, , 2001. Table I summarizes the preparative regimens used.…”

Use of Oseltamivir to control influenza complications after bone marrow transplantation

“…Although influenza continues to cause annual, worldwide epidemics, and a higher risk of complication in BMT recipients, [1][2][3][4] surprisingly few studies have addressed the impact of influenza vaccination or of early, antiviral intervention with the new neuraminidase (NA) inhibitors, Zanamivir and Oseltamivir. [5][6][7] Oseltamivir is a potent and selective inhibitor of the NA glycoprotein, essential for replication of the influenza A and B viruses. This drug inhibits sialidase activity, and compared to Amantadine, provides clear advantages such as activity against both influenza A and B viruses, an improved safety profile, and a low potential for inducing resistance.…”