Safety and immunogenicity of the live attenuated varicella vaccine following T replete or T cell-depleted related and unrelated allogeneic hematopoietic cell transplantation (alloHCT) Journal Article


Authors: Chou, J. F.; Kernan, N. A.; Prockop, S.; Heller, G.; Scaradavou, A.; Kobos, R.; Knowles, M. A.; Papadopoulos, E. B.; Casson, A.; Copeland, C.; Torok-Castanza, J.; Zakak, N.; Ruggiero, J.; Small, T. N.
Article Title: Safety and immunogenicity of the live attenuated varicella vaccine following T replete or T cell-depleted related and unrelated allogeneic hematopoietic cell transplantation (alloHCT)
Abstract: There are limited studies assessing the live attenuated varicella vaccine following allogeneic hematopoietic cell transplantation (alloHCT). Because of the morbidity of varicella acquired after childhood, we immunized and retrospectively analyzed the safety and immunogenicity of this vaccine in 46 varicella zoster virus (VZV) seronegative patients <20 years old at HCT who achieved a CD4 cell count ≥200/μL, were off immunosuppression, and responded to ≥1 post-HCT vaccines. Two vaccinated patients lacking follow-up titers were excluded from analysis. Stem cells were derived from an HLA-matched sibling (n = 18) or an alternative (HLA mismatched related or unrelated) donor (n = 26). Median time to vaccination was 4 years. Sixty-four percent of patients seroconverted following 1 immunization. There was no significant difference in response between recipients of a matched related or alternative donor graft (P = .2) or between those given a T cell-depleted or T-replete alternative donor graft (P = .27). Three of 44 patients developed a self-limited varicella-like rash within 2.5 weeks of immunization. With a median follow-up of 29.1 (range: 6.9-167.1) months, there were no subsequent cases of varicella-like rashes. No patient developed shingles. This study suggests that this vaccine is safe and immunogenic when given according to preset clinical and immunologic milestones, warranting larger prospective studies in patients ≥24 months following HCT as outlined in current post-HCT vaccine guidelines. © 2011 American Society for Blood and Marrow Transplantation.
Keywords: adolescent; adult; child; clinical article; child, preschool; retrospective studies; transplantation, homologous; young adult; drug safety; t lymphocyte; t-lymphocytes; hematopoietic stem cell transplantation; retrospective study; infant; infant, newborn; immunogenicity; cd4+ t lymphocyte; vaccination; allogeneic hematopoietic stem cell transplantation; infection prevention; chickenpox vaccine; chickenpox; live vaccine; antibody titer; immunization; allogeneic; herpesvirus 3, human; seroconversion; vaccines, attenuated; varicella
Journal Title: Biology of Blood and Marrow Transplantation
Volume: 17
Issue: 11
ISSN: 1083-8791
Publisher: Elsevier Inc.  
Date Published: 2011-11-01
Start Page: 1708
End Page: 1713
Language: English
DOI: 10.1016/j.bbmt.2011.05.006
PROVIDER: scopus
PUBMED: 21664979
PMCID: PMC3660138
DOI/URL:
Notes: --- - "Export Date: 9 December 2011" - "CODEN: BBMTF" - "Source: Scopus"
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MSK Authors
  1. Joanne Fu-Lou Chou
    332 Chou
  2. Nancy Kernan
    512 Kernan
  3. Trudy Small
    234 Small
  4. Glenn Heller
    399 Heller
  5. Susan E Prockop
    262 Prockop
  6. Nicole Zakak
    16 Zakak
  7. Anne Regan Casson
    23 Casson
  8. Rachel Kobos
    75 Kobos