Abstract
The guidelines for immunization of hematopoietic SCT (HSCT) recipients recommend three doses of antipneumococcal conjugate vaccine (PCV) from 3 to 6 months after transplant, followed by a dose of polysaccharide 23-valent (PPV23) vaccine at 12 months in the case of no GVHD or an additional PCV dose in the case of GVHD. Due to the lack of long-term data in the literature, there is no recommendation for boosts after 12 months. Our goal was to assess the maintenance of the immune response to pneumococcal vaccines in patients vaccinated 10 years ago according to current guidelines. Thirty surviving patients of the IDWP01 (Infectious Diseases Working Party 1) trial were assessed for antibody levels against the seven antigens of the PCV7 and against two of the PPV23-specific antigens. When compared with 24 months after transplant, the immune response did not significantly decrease but with important serotype-specific variability. There was no evidence that an additional dose of PPV23 given to 11/30 patients 2–11 years after transplant was beneficial. In long-term HSCT survivors with no or few GVHD vaccinated against Streptococcus pneumoniae according to the current guidelines, the specific immunity is not fully maintained a decade later. The optimal schedule of antipneumococcal vaccination in HSCT recipients after 12 months remains to be established.
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Acknowledgements
We are grateful to Luca Mollo, MD (Medical Director Vaccines, Pfizer, France) and Veronique Schindler (IIR Manager, Pfizer France), Linda Xu (Data management and logistics, Vaccines R and D, Pfizer Laboratories, Pearl River, US) and Adriana Cahill (WW Research &Development, Vaccines R and D, Pfizer Laboratories, Pearl River, US) for their help in the organization of the study and the laboratory assessments. We also thank the staff of the Plateforme de Ressources Biologiques of Henri Mondor University Hospital, especially Dr Bijan Ghaleh and Dr Caroline Barau, and Dr Oumedaly Reman, Caen University Hospital. This work was supported by Pfizer France.
Author contributions
CC and PL: study concept and design, funding, acquisition of data, analysis and interpretation of data and drafting the manuscript. ML: statistical analysis and drafting the manuscript. PR: study concept, acquisition of data and analysis and interpretation of data. CR, LC and CCh: data collection and analysis and interpretation of data. SC: critical revision of the manuscript.
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Dr Cordonnier served on Pfizer advisory boards and speaker bureau and received research funding for her department. Dr Ribaud served on Pfizer advisory boards and speaker bureau. Dr Ljungman has been an investigator on a subsequent Pfizer sponsored study and participated on behalf of his department in a Pfizer advisory board. The remaining authors declare no potential conflict of interest.
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Cordonnier, C., Labopin, M., Robin, C. et al. Long-term persistence of the immune response to antipneumococcal vaccines after Allo-SCT: 10-year follow-up of the EBMT-IDWP01 trial. Bone Marrow Transplant 50, 978–983 (2015). https://doi.org/10.1038/bmt.2015.42
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DOI: https://doi.org/10.1038/bmt.2015.42
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