Transfer of influenza vaccine-primed costimulated autologous T cells after stem cell transplantation for multiple myeloma leads to reconstitution of influenza immunity: results of a randomized clinical trial.
Severe immune deficiency follows autologous stem cell transplantation for multiple myeloma and is associated with significant infectious morbidity. This study was designed to evaluate the utility of a pretransplantation vaccine and infusion of a primed autologous T-cell product in stimulating specific immunity to influenza. Twenty-one patients with multiple myeloma were enrolled from 2007 to 2009. Patients were randomly assigned to receive an influenza-primed autologous T-cell product or a nonspecifically primed autologous T-cell product. The study endpoint was the development of hemagglutination inhibition titers to the strain-specific serotypes in the influenza vaccine. Enzyme-linked immunospot assays were performed to confirm the development of influenza-specific B-cell and T-cell immunity. Patients who received the influenza-primed autologous T-cell product were significantly more likely to seroconvert in response to the influenza vaccine (P = .001). Seroconversion was accompanied by a significant B-cell response. No differences were observed in the global quantitative recovery of T-cell and B-cell subsets or in global T-cell and B-cell function. The provision of a primed autologous T-cell product significantly improved subsequent influenza vaccine responses. This trial was registered at www.clinicaltrials.gov as #NCT00499577.
Stadtmauer
Edward A
EA
Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.
Vogl
Dan T
DT
Luning Prak
Eline
E
Boyer
Jean
J
Aqui
Nicole A
NA
Rapoport
Aaron P
AP
McDonald
Kenyetta R
KR
Hou
Xiaoling
X
Murphy
Heather
H
Bhagat
Rita
R
Mangan
Patricia A
PA
Chew
Anne
A
Veloso
Elizabeth A
EA
Levine
Bruce L
BL
Vonderheide
Robert H
RH
Jawad
Abbas F
AF
June
Carl H
CH
Sullivan
Kathleen E
KE
D019264:Adoptive Transfer; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000276:immunology / Q000627:therapeutic use*; D007251:Influenza, Human / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000276:immunology* / Q000628:therapy*; D033581:Stem Cell Transplantation; D013601:T-Lymphocytes / Q000637:transplantation*; D014182:Transplantation, Autologous; D014611:Vaccination
D007252:Influenza Vaccines