Safety and Immunogenicity of the Tetravalent Protein-Conjugated Meningococcal Vaccine (MCV4) in Recipients of Related and Unrelated Allogeneic Hematopoietic Stem Cell Transplantation Journal Article

   

Authors:	Mahler, M. B.; Taur, Y.; Jean, R.; Kernan, N. A.; Prockop, S. E.; Small, T. N.
Article Title:	Safety and Immunogenicity of the Tetravalent Protein-Conjugated Meningococcal Vaccine (MCV4) in Recipients of Related and Unrelated Allogeneic Hematopoietic Stem Cell Transplantation
Abstract:	Given the high morbidity and mortality associated with meningococcal disease, in 2007 the Advisory Committee of Immunization Practices recommended immunization of all children ages 11-18 with a protein-conjugated meningococcal vaccine. There are limited data on the immunogenicity of this vaccine after allogeneic hematopoietic stem cell transplantation (allo-HCT). Since 2007, we have immunized 48 patients with the MCV4 vaccine. Two vaccinated patients who lacked follow-up titers were excluded from this analysis. Stem cells were derived from an HLA-identical sibling (n = 17) or an alternative donor (n = 29). The median time to vaccination was 2.34 years after allo-HCT. Only 7 patients responded to all 4 serogroups, and 16 patients responded to none of the serogroups. The response to serogroups A, C, Y, and W-135 was 52%, 30%, 46%, and 33%, respectively. The ability to respond to 2 or more serogroups was not affected by age, diagnosis, time to vaccination, or history of graft-versus-host disease. Receipt of a T cell-depleted graft was associated with a poorer response (P = .044). Eight of 16 patients who received a second MCV4 vaccination responded to all 4 serogroups. This retrospective study suggests that response to a single MCV4 vaccination is poor after allo-HCT. Administration of a 2-dose series, as currently recommended for patients with asplenia, complement deficiency, and HIV infection, should be evaluated in this patient population. © 2012 American Society for Blood and Marrow Transplantation.
Keywords:	adolescent; adult; child; clinical article; controlled study; school child; treatment response; retrospective studies; young adult; human cell; drug safety; unspecified side effect; rituximab; follow up; hematopoietic stem cell transplantation; retrospective study; age; stem cell; chronic graft versus host disease; donor; immunoglobulin g; immunogenicity; vaccination; allogeneic hematopoietic stem cell transplantation; t cell depletion; graft recipient; meningococcus vaccine; hla system; immunization; antibodies, bacterial; transplant; seroconversion; meningococcal vaccines; meningococcus; meningococcal infections
Journal Title:	Biology of Blood and Marrow Transplantation
Volume:	18
Issue:	1
ISSN:	1083-8791
Publisher:	Elsevier Inc.
Date Published:	2012-01-01
Start Page:	145
End Page:	149
Language:	English
DOI:	10.1016/j.bbmt.2011.07.027
PROVIDER:	scopus
PMCID:	PMC3286795
PUBMED:	21820392
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84855471315&partnerID=40&md5=3fab7cc95526b67eec8dd67edc915e2a
Notes:	--- - "Export Date: 1 March 2012" - "CODEN: BBMTF" - "Source: Scopus"

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