Safety of vaccinating sibling donors with live-attenuated varicella zoster vaccine before hematopoietic stem cell transplantation.
Reactivation of varicella zoster virus (VZV), clinically manifested as herpes zoster (HZ) is a common complication after hematopoietic stem cell transplantation (HSCT). The optimum prophylaxis for this disease has not been defined. In this study, we examined the effects of vaccinating donors with a live-attenuated vaccine with particular reference to their immune responses and the outcome of HSCT patients. Forty prospective HLA-matched sibling donors were vaccinated before HSCT. There were humoral immune responses in both sero-positive (P<0.01) and sero-negative (P=0.058) donors. Cellular immune response was assayed in 26 donors. Significant correlation was observed between cellular immune responses as enumerated by thymidine incorporation and interferon gamma secretion (P<0.001) and the latter was used in subsequent analyses. Significant response was observed in sero-negative (6/26) and a group of sero-positive (13/26) donors while 7/26 sero-positive donors showed no response. Thirty-four HSCT were performed. These patients have a lower, albeit insignificant, risk of HZ compared with historical controls and only 3/34 patients developed single dermatomal HZ at 6, 9 and 28 months after HSCT. No patients developed VZV-related mortality. Vaccinating donors with live-attenuated VZV vaccine was safe, but whether it confers a significant protection to the patients would require further study.
Leung
A Y H
AY
Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China. ayhleung@hku.hk
Chow
H C H
HC
Kwok
J S Y
JS
Lui
C K H
CK
Cheng
V C C
VC
Yuen
K-Y
KY
Lie
A K W
AK
Liang
R
R
D000293:Adolescent; D000328:Adult; D019433:Chickenpox Vaccine / Q000008:administration & dosage*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006562:Herpes Zoster / Q000517:prevention & control*; D006801:Humans; D007938:Leukemia / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012449:Safety; D035781:Siblings; D014019:Tissue Donors; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D019433:Chickenpox Vaccine