title: Antibody response to polysaccharide conjugate vaccines after nonmyeloablative allogeneic stem cell transplantation.
abstract: After allogeneic stem cell transplantation with reduced-intensity conditioning regimens (allo-RIST) patients are susceptible to bacterial and viral infections for a period that may last several years. The efficacy of the recommended vaccination schedules, in terms of induction of a protective antibody response, is unknown. In this study, the reconstitution of humoral immunity after allo-RIST is determined by measuring the vaccination-induced antibody response against Streptococcus pneumoniae, Haemophilus influenzae type b (Hib), and tetanus toxoid (TT) 1 year posttransplantation. Patients who underwent allo-RIST were vaccinated according to a schedule starting at 12 months following transplantation with conjugated vaccines against S. pneumoniae, Hib, and TT. Of twenty-six patients both pre- and postvaccination sera were available. Patients were required to be off immunosuppression at the time of vaccination, and, therefore, 9 of the 26 patients did not start vaccination at 12 months post-stem cell transplantation but rather at a median range of 15 (12-36 months) posttransplantation. Except for pneumococcal serotype 6B, more than 73% of the patients developed antibody levels >or=0.35 microg/mL for all pneumococcal serotypes included in the vaccine. For Hib and TT, protective antibody levels were found in 77% and 96% of the patients, respectively. Vaccination of patients at a median of 15 months post-allo-RIST leads to significant rise in concentrations of pneumococcal, Hib, and TT antibodies in the majority of patients.
authors.affiliation: Department of Internal Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Aafke
authors.initials: A
authors.lastname: Meerveld-Eggink
authors.forename: Ankie M T
authors.initials: AM
authors.lastname: van der Velden
authors.forename: Gert J
authors.initials: GJ
authors.lastname: Ossenkoppele
authors.forename: Arjan A
authors.initials: AA
authors.lastname: van de Loosdrecht
authors.forename: Douwe H
authors.initials: DH
authors.lastname: Biesma
authors.forename: Ger T
authors.initials: GT
authors.lastname: Rijkers
mesh_terms: D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000096:biosynthesis* / Q000276:immunology; D005260:Female; D019741:Haemophilus influenzae type b / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000276:immunology*; D033581:Stem Cell Transplantation; D013296:Streptococcus pneumoniae / Q000276:immunology; D013745:Tetanus Toxoid / Q000276:immunology; D019172:Transplantation Conditioning / Q000379:methods; D018074:Vaccines, Conjugate / Q000008:administration & dosage / Q000276:immunology
chemical_list: D000907:Antibodies, Bacterial; D022242:Pneumococcal Vaccines; D013745:Tetanus Toxoid; D018074:Vaccines, Conjugate