title: Efficacy of donor vaccination before hematopoietic cell transplantation and recipient vaccination both before and early after transplantation.
abstract: 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.
authors.affiliation: Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA 98109-1024, USA. jstorek@fhcrc.org
authors.forename: J
authors.initials: J
authors.lastname: Storek
authors.forename: M A
authors.initials: MA
authors.lastname: Dawson
authors.forename: L C-L
authors.initials: LC
authors.lastname: Lim
authors.forename: B E
authors.initials: BE
authors.lastname: Burman
authors.forename: T
authors.initials: T
authors.lastname: Stevens-Ayers
authors.forename: F
authors.initials: F
authors.lastname: Viganego
authors.forename: M M P T
authors.initials: MM
authors.lastname: Herremans
authors.forename: M E D
authors.initials: ME
authors.lastname: Flowers
authors.forename: R P
authors.initials: RP
authors.lastname: Witherspoon
authors.forename: D G
authors.initials: DG
authors.lastname: Maloney
authors.forename: M
authors.initials: M
authors.lastname: Boeckh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000906:Antibodies / Q000097:blood; D000917:Antibody Formation; D000942:Antigens, Bacterial / Q000008:administration & dosage / Q000276:immunology; D016667:Bacterial Capsules / Q000008:administration & dosage / Q000276:immunology; D004334:Drug Administration Schedule; D005260:Female; D006193:Haemophilus influenzae / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006514:Hepatitis B Surface Antigens / Q000008:administration & dosage / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013296:Streptococcus pneumoniae / Q000276:immunology; D013745:Tetanus Toxoid / Q000008:administration & dosage / Q000276:immunology; D013997:Time Factors; D014019:Tissue Donors; D014184:Transplantation, Homologous; D014611:Vaccination / Q000009:adverse effects / Q000379:methods*
chemical_list: D000906:Antibodies; D000942:Antigens, Bacterial; D006514:Hepatitis B Surface Antigens; D013745:Tetanus Toxoid