Efficacy of donor vaccination before hematopoietic cell transplantation and recipient vaccination both before and early after transplantation

• Published in: Bone marrow transplantation (Basingstoke) Vol. 33; no. 3; pp. 337 - 346
• Main Authors: STOREK, J, DAWSON, M. A, BOECKH, M, LIM, L. C.-L, BURMAN, B. E, STEVENS-AYERS, T, VIGANEGO, F, HERREMANS, M. M. P. T, FLOWERS, M. E. D, WITHERSPOON, R. P, MALONEY, D. G
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01-02-2004
• Subjects: Adolescent; Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antibodies; Antibodies - blood; Antibody Formation; Antigens; Antigens, Bacterial - administration & dosage; Antigens, Bacterial - immunology; Bacterial Capsules - administration & dosage; Bacterial Capsules - immunology; Biological and medical sciences; Bone marrow, stem cells transplantation. Graft versus host reaction; Conjugates; Drug Administration Schedule; Female; Haemophilus influenzae; Haemophilus influenzae - immunology; Hematopoietic Stem Cell Transplantation - methods; Hepatitis; Hepatitis B; Hepatitis B surface antigen; Hepatitis B Surface Antigens - administration & dosage; Hepatitis B Surface Antigens - immunology; Humans; Immunization; Immunodeficiency; Immunogenicity; Immunoglobulin G; Male; Medical sciences; Middle Aged; Polysaccharides; Proteins; Recall; Saccharides; Stem cell transplantation; Streptococcus infections; Streptococcus pneumoniae; Streptococcus pneumoniae - immunology; Tetanus; Tetanus Toxoid - administration & dosage; Tetanus Toxoid - immunology; Time Factors; Tissue Donors; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Transplantation, Homologous; Vaccination; Vaccination - adverse effects; Vaccination - methods; Vaccines; Prevention; Immunoprophylaxis; Immunization; Treatment; Donor; Hematology; Antibody; hematopoietic cell transplantation; Vaccination; Hematopoietic cell; antibody levels; Recipient
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/sj.bmt.1704336

Allogeneic hematopoietic cell transplantation is followed by humoral immunodeficiency. We evaluated whether antibody levels can be improved by recipient vaccination on day -1 and 50 and whether the levels can be further improved by donor vaccination on day -20. A total of 85 patients were randomized or assigned to one of the following strategies of immunization with Streptococcus pneumoniae polysaccharides, Haemophilus influenzae polysaccharide-protein conjugate, tetanus toxoid (protein recall antigen) and hepatitis B surface antigen (protein neo-antigen): (1) donor on day -20, recipient on days -1, +50 and +365 (D(-20)R(-1,50,365)); (2) donor nil, recipient on days -1, +50 and +365 (D(N)R(-1,50,365)); or (3) donor nil, recipient on day +365 (D(N)R(365)). For H. influenzae and tetanus, IgG levels after grafting were the highest in the D(-20)R(-1,50,365) patients, intermediate in the D(N)R(-1,50,365) patients and the lowest in the D(N)R(365) patients. For S. pneumoniae and hepatitis B, antibody levels appeared to be similar in all three patient groups. The results suggest that for polysaccharide-protein conjugate antigens or protein recall antigens, recipient immunization on days -1 and 50 improves antibody levels and that donor vaccination on day -20 further improves the levels. In contrast, neither recipient immunization on days -1 and 50 nor donor immunization on day -20 appears to be efficacious for polysaccharide antigens and poorly immunogenic protein neo-antigens.