Vaccination responses and lymphocyte subsets after autologous stem cell transplantation.
Twenty autologous stem cell transplant recipients were vaccinated with three doses of Diphtheria-Tetanus-Poliomyelitis vaccine and conjugated Haemophilus influenzae type b (Hib) vaccine. Pneumococcal vaccination consisted of two doses of conjugated vaccine followed by a single dose of polysaccharide vaccine, at 6, 8 and 14 months after transplantation, respectively. Mean anti-tetanus, anti-Hib and anti-pneumococcal IgG antibodies significantly increased after each vaccination. Response rates after the full vaccination schedule were 94%, 78% and 61% for Hib, conjugated 7-valent pneumococcal vaccine and non-conjugated 23-valent pneumococcal vaccine, respectively. Three months after transplantation, CD16(+)CD56(+) NK cells were in the normal range and remained so. The total number of T lymphocytes at 3 months was and remained in the normal range. The mean CD4/CD8 ratio was 0.43 at 3 months post aSCT and, while gradually increasing, remained subnormal. The mean number of CD19(+) B lymphocytes significantly increased during the study period. Patients with CD19 counts <0.10 x 10(9)L(-1) required at least two Hib vaccinations to show a response, while the majority of patients with CD19 counts > or = 0.20 x 10(9)L(-1) showed a response to Hib after one vaccination only. Thus, a minimum threshold level of CD19(+) cells appears to be required for adequate responses to vaccination.
van der Velden
A M T
AM
Department of Internal Medicine, Sint Antonius Hospital, Nieuwegein, The Netherlands. am.vandervelden@vumc.nl
Claessen
A M E
AM
van Velzen-Blad
H
H
de Groot
M R
MR
Kramer
M H H
MH
Biesma
D H
DH
Rijkers
G T
GT
D000328:Adult; D000368:Aged; D000686:Amyloidosis / Q000276:immunology; D000906:Antibodies / Q000032:analysis; D016175:B-Lymphocyte Subsets / Q000276:immunology*; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D018073:Haemophilus Vaccines / Q000276:immunology; D019741:Haemophilus influenzae type b / Q000276:immunology; D006801:Humans; D007115:Immunization Schedule; D007074:Immunoglobulin G / Q000276:immunology; D008228:Lymphoma, Non-Hodgkin / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000276:immunology; D010641:Phenotype; D011446:Prospective Studies; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous / Q000276:immunology*; D014611:Vaccination; D018074:Vaccines, Conjugate / Q000276:immunology
D000906:Antibodies; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D018073:Haemophilus Vaccines; D007074:Immunoglobulin G; D018074:Vaccines, Conjugate