title: Serum IgM levels independently predict immune response to influenza vaccine in long-term survivors vaccinated at >1 year after undergoing allogeneic hematopoietic stem cell transplantation.
abstract: Influenza virus infection can cause fatal complications (e.g., pneumonia) in immunodeficient long-term survivors of allogeneic hematopoietic stem cell transplantation (allo-HSCT). The immune response to the vaccine improves if it is administered at >1 year after allo-HSCT, although the response may vary according to the patient's immune status. We sought to identify predictors of immune response to trivalent inactivated influenza vaccine (TIV) among patients vaccinated at >1 year after allo-HSCT. We included 27 allo-HSCT recipients, with a median interval of 4.3 years (range 1.0-10.1 years) from transplantation to vaccination. Nineteen patients achieved a response to TIV, although a low immune response to TIV was significantly associated with calcineurin inhibitor treatment, and moderate chronic graft-versus-host disease and IgM levels of <0.5 g/L at the time of vaccination. Multivariate analysis revealed that IgM levels of <0.5 g/L at the vaccination were an independent predictor of a low immune response to TIV. These results indicate that a more effective approach is needed to induce a vaccine-specific immune response among long-term survivors of allo-HSCT who have low serum IgM levels.
authors.affiliation: Division of Hematology, Internal Medicine 3, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Fukatsu
authors.affiliation: Division of Hematology, Internal Medicine 3, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Nagata
authors.affiliation: Division of Hematology, Internal Medicine 3, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan.
authors.forename: Miwa
authors.initials: M
authors.lastname: Adachi
authors.affiliation: Division of Hematology, Internal Medicine 3, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Yagyu
authors.affiliation: Division of Hematology, Internal Medicine 3, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan. takaono@hama-med.ac.jp.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Ono
mesh_terms: D000328:Adult; D064591:Allografts; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology; D007075:Immunoglobulin M / Q000097:blood*; D007252:Influenza Vaccines / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D013534:Survival; D013997:Time Factors; D014611:Vaccination
chemical_list: D007075:Immunoglobulin M; D007252:Influenza Vaccines
keywords: Allogeneic hematopoietic stem cell transplantation; IgM; Influenza vaccine; Predictive biomarker