Korean J Pediatr Infect Dis.  2014 Aug;21(2):81-95.

Antibody Responses in Hematopoietic Cell Transplantation Recipients after Vaccination Against Haemophilus Influenzae Type b and Streptococcus pneumoniae

Affiliations
  • 1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 2Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 3Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
  • 4Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea. kaykim@ewah.ac.kr
  • 5Center for Vaccine Evaluation and Study, School of Medicine, Ewha Womans University, Seoul, Korea.

Abstract

PURPOSE
Hematopoietic cell transplantation (HCT) recipients are vulnerable to invasive infection by Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae (Sp). This study was performed to evaluate immune responses after Hib and Sp 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 for Vaccine 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) were enrolled. Before Hib vaccination, 60% of patients' anti-PRP IgG titers were below 0.15 microg/mL. After vaccination, 100% of patients' anti-PRP IgG titers increased above 0.15 microg/mL (cut-off value for detection) and 1.0 microg/mL (cut-off value for seroprotection). For pneumococcus, in 2-5 year-old patients, pre-vaccination geometric mean concentrations (GMCs) of IgG for six serotypes (4, 6B, 9V, 14, 18C, and 23F) were below 0.35 microg/mL and at 5 months post-vaccination GMCs of IgG for all seven serotypes increased to above 0.35 microg/mL. In patients older than 5 years, pre-vaccination GMCs of IgG for four serotypes (4, 9V, 14, and 23F) were below 0.35 microg/mL and at 3 months post-vaccination GMCs of IgG for all seven serotypes increased to above 0.35 microg/mL.
CONCLUSION
Most HCT recipients had low or no protective antibodies to Hib and Sp before vaccination, but showed good immune responses to protective levels after vaccination.

Keyword

Stem cell transplant; vaccination; Hib; Pneumococcus

MeSH Terms

Academies and Institutes
Antibodies
Antibody Formation*
Cell Transplantation*
Enzyme-Linked Immunosorbent Assay
Haemophilus influenzae type b*
Humans
Immunoglobulin G
Prospective Studies
Streptococcus pneumoniae*
Transplants*
Vaccination*
Antibodies
Immunoglobulin G
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