title: 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.
abstract: 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.
authors.affiliation: Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Stadtmauer
authors.forename: Dan T
authors.initials: DT
authors.lastname: Vogl
authors.forename: Eline
authors.initials: E
authors.lastname: Luning Prak
authors.forename: Jean
authors.initials: J
authors.lastname: Boyer
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Aqui
authors.forename: Aaron P
authors.initials: AP
authors.lastname: Rapoport
authors.forename: Kenyetta R
authors.initials: KR
authors.lastname: McDonald
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Hou
authors.forename: Heather
authors.initials: H
authors.lastname: Murphy
authors.forename: Rita
authors.initials: R
authors.lastname: Bhagat
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Mangan
authors.forename: Anne
authors.initials: A
authors.lastname: Chew
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Veloso
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Levine
authors.forename: Robert H
authors.initials: RH
authors.lastname: Vonderheide
authors.forename: Abbas F
authors.initials: AF
authors.lastname: Jawad
authors.forename: Carl H
authors.initials: CH
authors.lastname: June
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Sullivan
mesh_terms: 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
chemical_list: D007252:Influenza Vaccines