Immunity after (re)vaccination of paediatric patients following haematopoietic stem cell transplantation

• Published in: Acta Paediatrica Vol. 101; no. 8; pp. e373 - e377
• Main Authors: Olkinuora, Helena, Käyhty, Helena, Davidkin, Irja, Roivainen, Merja, Ölander, Rose-Marie, Kantele, Jussi M, Siitonen, Sanna, Vettenranta, Kim
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.08.2012; Wiley Subscription Services, Inc
• Subjects: Adolescent; Antibodies, Bacterial - blood; Antibodies, Viral - blood; Bone marrow; Child; Child, Preschool; Diphtheria Toxin - immunology; Flow Cytometry; Graft vs Host Disease - immunology; Haemophilus influenzae type b - immunology; Hematopoietic Stem Cell Transplantation; Humans; Immunodeficiency; Measles virus - immunology; Pediatric oncology; Poliovirus - immunology; Postoperative Care; Prospective Studies; Stem cells; Streptococcus pneumoniae - immunology; Tetanus Toxin - immunology; Transplantation Immunology; Transplants & implants; Vaccination; Vaccine response; Vaccines - immunology; Young Adult
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/j.1651-2227.2012.02710.x

Aims:  Loss of specific immunity follows allogeneic haematopoietic stem cell transplantation (HSCT) in the majority of cases. Responses to (re)vaccinations can be used as indicators of a functional immunological recovery. Methods:  Twenty‐three paediatric recipients of HSCT were enrolled in a single centre setting and responses to scheduled immunizations analysed. Results:  Immunity to vaccine‐preventable diseases was impaired post HSCT, but (re)vaccinations induced protective responses in 59–100%, depending on the vaccine, regardless of prior graft‐versus‐host disease (GVHD) history. Conclusion:  Despite the marked impact of moderate to severe chronic prior GVHD on both the qualitative and quantitative T‐cell recovery post allogenic HSCT, most paediatric recipients of allogeneic stem cell grafts appear to attain protective antibody levels after immunization.