title: Enhanced immune response after a second dose of an AS03-adjuvanted H1N1 influenza A vaccine in patients after hematopoietic stem cell transplantation.
abstract: Seroconversion rates following influenza vaccination in patients with hematologic malignancies after hematopoietic stem cell transplantation (HSCT) are known to be lower compared to healthy adults. The aim of our diagnostic study was to determine the rate of seroconversion after 1 or 2 doses of a novel split virion, inactivated, AS03-adjuvanted pandemic H1N1 influenza vaccine (A/California/7/2009) in HSCT recipients (ClinicalTrials.gov Identifier: NCT01017172). Blood samples were taken before and 21 days after a first dose and 21 days after a second dose of the vaccine. Antibody (AB) titers were determined by hemagglutination inhibition assay. Seroconversion was defined by either an AB titer of ≤ 1:10 before and ≥ 1:40 after or ≥ 1:10 before and ≥ 4-fold increase in AB titer 21 days after vaccination. Seventeen patients (14 allogeneic, 3 autologous HSCT) received 1 dose and 11 of these patients 2 doses of the vaccine. The rate of seroconversion was 41.2% (95% confidence interval [CI] 18.4-67.1) after the first and 81.8% (95% CI 48.2-97.7) after the second dose. Patients who failed to seroconvert after 1 dose of the vaccine were more likely to receive any immunosuppressive agent (P = .003), but time elapsed after or type of HSCT, age, sex, or chronic graft-versus-host disease was not different when compared to patients with seroconversion. In patients with hematologic malignancies after HSCT the rate of seroconversion after a first dose of an adjuvanted H1N1 influenza A vaccine was poor, but increased after a second dose.
authors.affiliation: Department of Medicine, Hematology/Oncology, Goethe-University of Frankfurt, Germany. saskia.gueller@kgu.de
authors.forename: Saskia
authors.initials: S
authors.lastname: Gueller
authors.forename: Regina
authors.initials: R
authors.lastname: Allwinn
authors.forename: Sabine
authors.initials: S
authors.lastname: Mousset
authors.forename: Hans
authors.initials: H
authors.lastname: Martin
authors.forename: Imke
authors.initials: I
authors.lastname: Wieters
authors.forename: Eva
authors.initials: E
authors.lastname: Herrmann
authors.forename: Hubert
authors.initials: H
authors.lastname: Serve
authors.forename: Markus
authors.initials: M
authors.lastname: Bickel
authors.forename: Gesine
authors.initials: G
authors.lastname: Bug
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood* / Q000276:immunology; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000097:blood / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D058873:Pandemics; D012737:Sex Factors; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D015164:Vaccines, Inactivated / Q000008:administration & dosage / Q000276:immunology
chemical_list: D000914:Antibodies, Viral; D007252:Influenza Vaccines; D015164:Vaccines, Inactivated