Predictive factors for vaccine failure to guide vaccination in allogeneic hematopoietic stem cell transplant recipients.
Janssen, Michelle J M Bruns, Anke H W Verduyn Lunel, Frans M Raijmakers, Reinier A P de Weijer, Roel J Nanlohy, Nening M Smits, Gaby P van Baarle, Debbie Kuball, Jürgen
Janssen, Michelle J M
Bruns, Anke H W
Verduyn Lunel, Frans M
Raijmakers, Reinier A P
de Weijer, Roel J
Nanlohy, Nening M
Smits, Gaby P
van Baarle, Debbie
Kuball, Jürgen
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Series / Report no.
Open Access
Type
Article
Language
en
Date of publication
2021-08-20
Year of publication
Research Projects
Organizational Units
Journal Issue
Title
Predictive factors for vaccine failure to guide vaccination in allogeneic hematopoietic stem cell transplant recipients.
Translated Title
Published in
Bone Marrow Transpl 2021; advance online publication (ahead of print)
Abstract
Vaccination after hematopoietic stem cell transplantation (HSCT) is essential to protect high-risk patients against potentially lethal infections. Though multiple studies have evaluated vaccine specific responses, no comprehensive analysis of a complete vaccination schedule post-HSCT has been performed and little is known about predictors for vaccine failure. In this context, allogeneic HSCT (alloHSCT) patients were included and vaccinated starting one year post-transplantation. Antibody responses were measured by Multiplex Immuno Assay for pneumococcal (PCV13), meningococcal C, diphtheria, pertussis, tetanus and Haemophilus influenza type b one month after the last vaccination and correlated to clinical and immunological parameters. Vaccine failure was defined as antibody response above vaccine-specific cut-off values for less than four out of six vaccines. Ninety-six patients were included of which 27.1% was found to have vaccine failure. Only 40.6% of all patients responded adequately to all six vaccines. In multivariate analysis, viral reactivation post-HSCT (OR 6.53; P = 0.03), B-cells <135 per mm3 (OR 7.24; P = 0.00) and NK-cells <170 per mm3 (OR 11.06; P = 0.00) were identified as predictors for vaccine failure for vaccination at one year post-alloHSCT. Measurement of antibody responses and an individualized approach for revaccination guided by clinical status and immune reconstitution of B-cells and NK-cells may improve vaccine responses.