Antibody Responses in Hematopoietic Cell Transplantation Recipients after Vaccination Against Haemophilus Influenzae Type b and Streptococcus pneumoniae
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Purpose: Hematopoietic cell transplantation (HCT) recipients are vulnerable to invasive infection by Haemophilus influenzaetype b (Hib) and Streptococcus pneumoniae (Sp). This study was performed to evaluate immune responses after Hib andSp vaccination in Korean pediatric HCT recipients. Methods: Patients were prospectively enrolled at Samsung Medical Center during 2009-2011. ELISA tests to detect anti-PRP IgG antibody and antibodies to Sp serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F were performed at the Center forVaccine Evaluation and Study, Ewha Medical Research Institute. Results: Ten patients (two allogeneic, eight autologous recipients) with median age 5.4 years (range 2.7-12.2 years) wereenrolled. Before Hib vaccination, 60% of patients’ anti-PRP IgG titers were below 0.15 μg/mL. After vaccination, 100% ofpatients’ anti-PRP IgG titers increased above 0.15 μg/mL (cut-off value for detection) and 1.0 μg/mL (cut-off value forseroprotection). For pneumococcus, in 2-5 year-old patients, pre-vaccination geometric mean concentrations (GMCs) ofIgG for six serotypes (4, 6B, 9V, 14, 18C, and 23F) were below 0.35 μg/mL and at 5 months post-vaccination GMCs ofIgG for all seven serotypes increased to above 0.35 μg/mL. In patients older than 5 years, pre-vaccination GMCs of IgGfor four serotypes (4, 9V, 14, and 23F) were below 0.35 μg/mL and at 3 months post-vaccination GMCs of IgG for allseven serotypes increased to above 0.35 μg/mL. Conclusion: Most HCT recipients had low or no protective antibodies to Hib and Sp before vaccination, but showed goodimmune responses to protective levels after vaccination.
Abstract
Purpose: Hematopoietic cell transplantation (HCT) recipients are vulnerable to invasive infection by Haemophilus influenzaetype b (Hib) and Streptococcus pneumoniae (Sp). This study was performed to evaluate immune responses after Hib andSp vaccination in Korean pediatric HCT recipients. Methods: Patients were prospectively enrolled at Samsung Medical Center during 2009-2011. ELISA tests to detect anti-PRP IgG antibody and antibodies to Sp serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F were performed at the Center forVaccine Evaluation and Study, Ewha Medical Research Institute. Results: Ten patients (two allogeneic, eight autologous recipients) with median age 5.4 years (range 2.7-12.2 years) wereenrolled. Before Hib vaccination, 60% of patients’ anti-PRP IgG titers were below 0.15 μg/mL. After vaccination, 100% ofpatients’ anti-PRP IgG titers increased above 0.15 μg/mL (cut-off value for detection) and 1.0 μg/mL (cut-off value forseroprotection). For pneumococcus, in 2-5 year-old patients, pre-vaccination geometric mean concentrations (GMCs) ofIgG for six serotypes (4, 6B, 9V, 14, 18C, and 23F) were below 0.35 μg/mL and at 5 months post-vaccination GMCs ofIgG for all seven serotypes increased to above 0.35 μg/mL. In patients older than 5 years, pre-vaccination GMCs of IgGfor four serotypes (4, 9V, 14, and 23F) were below 0.35 μg/mL and at 3 months post-vaccination GMCs of IgG for allseven serotypes increased to above 0.35 μg/mL. Conclusion: Most HCT recipients had low or no protective antibodies to Hib and Sp before vaccination, but showed goodimmune responses to protective levels after vaccination.
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