Immunogenicity of recombinant hepatitis B vaccine (rHBV) in recipients of unrelated or related allogeneic hematopoietic cell (HC) transplants Journal Article

Authors: Jaffe, D.; Papadopoulos, E. B.; Young, J. W.; O'Reilly, R. J.; Prockop, S.; Kernan, N. A.; Jakubowski, A.; Boulad, F.; Perales, M. A.; Castro-Malaspina, H.; Small, T. N.
Article Title: Immunogenicity of recombinant hepatitis B vaccine (rHBV) in recipients of unrelated or related allogeneic hematopoietic cell (HC) transplants
Abstract: Current European and US guidelines for recombinant hepatitis B vaccine (rHBV) after hematopoietic-cell transplantation (HCT) vary. The European Group for Blood and Marrow Transplantation (EBMT) recommends rHBV starting 6 to 12 months after HCT. Immunization is optional in the Centers for Disease Control and Prevention (CDC) guidelines. Nevertheless, rHBV is required for re-entry to school and certain workplaces. To determine the immunogenicity of rHBV following HCT, the prevaccine and postvaccine titers of 292 allogeneic transplant recipients who were immunized with rHBV were analyzed. Immunization was initiated in patients off immunosuppression who achieved specific minimal milestones of immune competence. Overall, 64% of patients seroconverted. In multivariate analyses, response was adversely affected by age older than 18 years (P < .01) and history of prior chronic graft-versus-host disease (GVHD; P < .001) but not by donor type or by use of T-cell depletion, adoptive immunotherapy, or rituximab. By comparison, 89% of rHBV nonresponders mounted a 3-fold or greater rise in polio titers following 3 doses of inactivated poliovirus. These data demonstrate that the rate of seroconversion following rHBV is lower in allogeneic HC transplant recipients compared with age-matched healthy controls. The data emphasize the need to document prevaccine and postvaccine titers to ensure response and suggest that immunization guidelines based on time interval from HCT, irrespective of immune competence, may not ensure adequate protection against certain vaccine-preventable diseases. © 2006 by The American Society of Hematology.
Keywords: adolescent; adult; child; controlled study; aged; child, preschool; middle aged; transplantation, homologous; major clinical study; anamnesis; dose response; hepatitis b; antineoplastic agents; rituximab; demography; hematopoietic stem cell transplantation; antibodies, monoclonal; chronic graft versus host disease; cellular immunity; infant; immunogenicity; allogeneic hematopoietic stem cell transplantation; multivariate analysis; protein folding; t cell depletion; immunosuppressive treatment; graft vs host disease; immunocompetence; immunization; poliomyelitis vaccine; recipient; blood donor; seroconversion; poliomyelitis; recombinant hepatitis b vaccine; poliomyelitis virus; hepatitis b vaccines
Journal Title: Blood
Volume: 108
Issue: 7
ISSN: 0006-4971
Publisher: American Society of Hematology  
Date Published: 2006-10-01
Start Page: 2470
End Page: 2475
Language: English
DOI: 10.1182/blood-2006-04-006981
PUBMED: 16763208
PROVIDER: scopus
PMCID: PMC1895570
Notes: --- - "Cited By (since 1996): 9" - "Export Date: 4 June 2012" - "CODEN: BLOOA" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Dana Jaffe
    13 Jaffe
  2. Nancy Kernan
    445 Kernan
  3. Trudy Small
    220 Small
  4. Farid Boulad
    288 Boulad
  5. Susan E Prockop
    200 Prockop
  6. Miguel-Angel Perales
    494 Perales
  7. James W Young
    285 Young
  8. Richard O'Reilly
    602 O'Reilly