Pertussis Immunity and Response to Tetanus-Reduced Diphtheria-Reduced Pertussis Vaccine (Tdap) after Autologous Peripheral Blood Stem Cell Transplantation Journal Article


Authors: Small, T. N.; Zelenetz, A. D.; Noy, A.; Rice, R. D.; Trippett, T. M.; Abrey, L.; Portlock, C. S.; Mccullagh, E. J.; Vanak, J. M.; Mulligan, A. M.; Moskowitz, C. H.
Article Title: Pertussis Immunity and Response to Tetanus-Reduced Diphtheria-Reduced Pertussis Vaccine (Tdap) after Autologous Peripheral Blood Stem Cell Transplantation
Abstract: Pertussis is a highly contagious respiratory infection characterized by prolonged cough and inspiratory whoop. Despite widespread vaccination of children aged < 7 years, its incidence is steadily increasing in adolescents and adults, because of the known decrease in immunity following childhood immunization. In an effort to reduce pertussis in adolescents and adults, 2 vaccines containing tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) (BOOSTRIX and Adacel) were licensed in 2005 for use in adolescents, 1 of which (Adacel) contains less pertussis toxoid (PT) for use in adults. This study assessed pertussis titers in 57 adult survivors of an autologous peripheral blood stem cell transplantation (PBSCT; median age, 37.5 years), 28 of whom were subsequently vaccinated with Tdap containing 2.5 μg of PT (Adacel). The median time to Tdap administration was 3 years posttransplantation. Before vaccination, 87% of the patients lacked pertussis immunity. Only 2 of the 28 patients developed a >2-fold response to PT following vaccination with Tdap. These data suggest that autologous transplantation recipients are highly susceptible to pertussis and that immunization with 2.5 μg of PT induces an inadequate response. Prospective trials evaluating BOOSTRIX, containing 8 μg/dose of PT (approved for adults in December 2008) are warranted in this vulnerable population undergoing transplantation. © 2009 American Society for Blood and Marrow Transplantation.
Keywords: adolescent; adult; controlled study; aged; disease-free survival; middle aged; young adult; major clinical study; cytarabine; rituximab; prospective studies; carboplatin; etoposide; cyclophosphamide; melphalan; transplantation; carmustine; ifosfamide; hodgkin disease; antibodies, monoclonal; nonhodgkin lymphoma; vaccination; drug response; lymphoma; oligodendroglioma; peripheral blood stem cell transplantation; graft recipient; infection sensitivity; diphtheria pertussis tetanus vaccine; pertussis; autologous peripheral blood stem cell transplantation; bacterial immunity; diphtheria; immunization; tetanus; vulnerable population; antibodies, bacterial; diphtheria-tetanus-pertussis vaccine; transplantation immunology; whooping cough
Journal Title: Biology of Blood and Marrow Transplantation
Volume: 15
Issue: 12
ISSN: 1083-8791
Publisher: Elsevier Inc.  
Date Published: 2009-12-01
Start Page: 1538
End Page: 1542
Language: English
DOI: 10.1016/j.bbmt.2009.07.018
PUBMED: 19896077
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 1" - "Export Date: 30 November 2010" - "CODEN: BBMTF" - "Source: Scopus"
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MSK Authors
  1. Trudy Small
    200 Small
  2. Carol Portlock
    181 Portlock
  3. Craig Moskowitz
    375 Moskowitz
  4. Ariela Noy
    208 Noy
  5. Andrew D Zelenetz
    556 Zelenetz
  6. Lauren E Abrey
    272 Abrey
  7. Jill M Vanak
    14 Vanak
  8. Robert D Rice
    27 Rice