title: Donor immunization with pneumococcal conjugate vaccine and early protective antibody responses following allogeneic hematopoietic cell transplantation.
abstract: Patients undergoing hematopoietic cell transplantation (HCT) are at increased risk for infections with Streptococcus pneumoniae and have long-lasting, impaired antibody responses to pneumococcal polysaccharide vaccines. We examined whether donor immunization with a heptavalent pneumococcal conjugate vaccine (PCV7) would elicit protective antibody responses to additional doses of vaccine administered early after transplantation. Ninety-six patients scheduled to receive an allogeneic hematopoietic cell transplant were randomized with their donors to receive either a dose of PCV7 vaccine or no vaccine before transplantation. All patients received PCV7 at 3 months, 6 months, and 12 months following transplantation, and serotype-specific antibody concentrations were determined after each dose. Following HCT, geometric mean antibody concentrations of patients in the immunized donor group were significantly higher for 5 of the 7 vaccine serotypes after one dose (P <.05) and for 4 of the 7 serotypes after 2 doses of vaccine (P <.03). Sixty-seven percent of patients in the immunized donor group had presumed protective IgG concentrations more than or equal to 0.50 microg/mL to all 7 serotypes following the first dose of vaccine compared to 36% in the unimmunized donor group (P =.05). After the third dose of vaccine, both groups had more than 60% of patients with concentrations at least 0.50 microg/mL to all vaccine serotypes. Donor immunization enhances early antibody responses of patients undergoing HCT to pneumococcal conjugate vaccine. A 3-dose schedule of PCV7 vaccine at 3, 6, and 12 months is immunogenic in these patients regardless of donor immunization.
authors.affiliation: Massachusetts Biologic Laboratories, University of Massachusetts Medical School, Jamaica Plain, MA 02130, USA. deborah.molrine@state.ma.us
authors.forename: Deborah C
authors.initials: DC
authors.lastname: Molrine
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Antin
authors.forename: Eva C
authors.initials: EC
authors.lastname: Guinan
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Soiffer
authors.forename: Kristin
authors.initials: K
authors.lastname: MacDonald
authors.forename: Richard
authors.initials: R
authors.lastname: Malley
authors.forename: Frank
authors.initials: F
authors.lastname: Malinoski
authors.forename: Susan
authors.initials: S
authors.lastname: Trocciola
authors.forename: Marjorie
authors.initials: M
authors.lastname: Wilson
authors.forename: Donna M
authors.initials: DM
authors.lastname: Ambrosino
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D000917:Antibody Formation / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007114:Immunization; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology; D013997:Time Factors; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000009:adverse effects; D018074:Vaccines, Conjugate / Q000008:administration & dosage / Q000276:immunology
chemical_list: D000907:Antibodies, Bacterial; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate