Robust vaccine responses in adult and pediatric cord blood transplantation recipients treated for hematologic malignancies Journal Article

Authors: Shah, G. L.; Shune, L.; Purtill, D.; Devlin, S.; Lauer, E.; Lubin, M.; Bhatt, V.; McElrath, C.; Kernan, N. A.; Scaradavou, A.; Giralt, S.; Perales, M. A.; Ponce, D. M.; Young, J. W.; Shah, M.; Papanicolaou, G.; Barker, J. N.
Article Title: Robust vaccine responses in adult and pediatric cord blood transplantation recipients treated for hematologic malignancies
Abstract: Because cord blood (CB) lacks memory T and B cells and recent decreases in herd immunity to vaccine-preventable diseases in many developed countries have been documented, vaccine responses in CB transplantation (CBT) survivors are of great interest. We analyzed vaccine responses in double-unit CBT recipients transplanted for hematologic malignancies. In 103 vaccine-eligible patients, graft-versus-host disease (GVHD) most commonly precluded vaccination. Sixty-five patients (63%; engrafting units median HLA-allele match 5/8; range, 2 to 7/8) received protein conjugated vaccines, and 63 patients (median age, 34 years; range, .9 to 64) were evaluated for responses. Median vaccination time was 17 months (range, 7 to 45) post-CBT. GVHD (n = 42) and prior rituximab (n = 13) delayed vaccination. Responses to Prevnar 7 and/or 13 vaccines (serotypes 14, 19F, 23F) were seen in children and adults (60% versus 49%, P = .555). Responses to tetanus, diphtheria, pertussis, Haemophilus influenzae, and polio were observed in children (86% to 100%) and adults (53% to 89%) even if patients had prior GVHD or rituximab. CD4+CD45RA+ and CD19+ cell recovery significantly influenced tetanus and polio responses. In a smaller cohort responses were seen to measles (65%), mumps (50%), and rubella (100%) vaccines. No vaccine side effects were identified, and all vaccinated patients survived (median follow-up, 57 months). Although GVHD and rituximab can delay vaccination, CBT recipients (including adults and those with prior GVHD) have similar vaccine response rates to adult donor allograft recipients supporting vaccination in CBT recipients. © 2015 American Society for Blood and Marrow Transplantation.
Keywords: adolescent; adult; child; major clinical study; prednisone; rituximab; allele; pneumococcus vaccine; cd20 antigen; cord blood stem cell transplantation; hematologic malignancy; whole body radiation; vaccination; graft versus host reaction; cd4 antigen; immunosuppressive treatment; graft recipient; cd19 antigen; vaccine; recombinant vaccine; cd45ra antigen; diphtheria pertussis tetanus vaccine; live vaccine; pertussis; hla system; diphtheria; tetanus; measles mumps rubella vaccine; poliomyelitis vaccine; immune reconstitution; adult disease; childhood disease; measles; mumps; rubella; cord blood transplantation; poliomyelitis; haemophilus influenzae; pneumococcal vaccines; human; article; vaccine response; diphtheria pertussis poliomyelitis tetanus hepatitis b vaccine; hepatitis a hepatitis b vaccine
Journal Title: Biology of Blood and Marrow Transplantation
Volume: 21
Issue: 12
ISSN: 1083-8791
Publisher: Elsevier Inc.  
Date Published: 2015-12-01
Start Page: 2160
End Page: 2166
Language: English
DOI: 10.1016/j.bbmt.2015.08.010
PROVIDER: scopus
PUBMED: 26271191
PMCID: PMC4672874
Notes: Export Date: 2 December 2015 -- Source: Scopus
Citation Impact
MSK Authors
  1. Nancy Kernan
    496 Kernan
  2. Sergio Andres Giralt
    844 Giralt
  3. Doris Ponce
    211 Ponce
  4. Miguel-Angel Perales
    690 Perales
  5. Juliet N Barker
    313 Barker
  6. James W Young
    309 Young
  7. Marissa N Lubin
    79 Lubin
  8. Sean McCarthy Devlin
    495 Devlin
  9. Valkal Bhatt
    61 Bhatt
  10. Leyla Osman Shune
    5 Shune
  11. Emily Jean Lauer
    15 Lauer
  12. Gunjan Lalitchandra Shah
    232 Shah