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A Randomized Trial of One vs. Two Doses of Influenza Vaccine Following Allogeneic Transplantation

tetano

Editor, Senior Moderator
Biol Blood Marrow Transplant. 2012 Aug 29. [Epub ahead of print]
A Randomized Trial of One vs. Two Doses of Influenza Vaccine Following Allogeneic Transplantation.
Karras NA, Weeres M, Sessions W, Xu X, Defor T, Young JA, Stefanski H, Brunstein C, Cooley S, Miller JS, Blazar BR, Wagner JE, Verneris MR.
Source

Division of Hematology/Oncology and Blood and Marrow Transplantation in the Department of Pediatrics, Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA.
Abstract

Influenza infection following allogeneic hematopoietic cell transplantation (allo-HCT) can result in severe complications. The effectiveness of the annual vaccine depends on age, immune competence and the antigenic potential of the 3 strains included (1). . We hypothesized that a second vaccine dose, the standard of care for vaccine-na?ve children, might improve post-HCT immune responses. Patients >60 days post-HCT were randomized to receive either 1 (n=33) or 2 (n=32) influenza vaccine doses separated by one month. The primary endpoint was whether two vaccinations induced superior immunity, however, we found no difference. Secondary endpoints were to identify variables associated with responses. Both hemagglutination inhibition (HAI) (p<0.005) and ELISpot responses (p=0.03) were greater for patients vaccinated ≥1 year post transplant. UCB recipients showed less IFN-γ responses (p=<0.001). Interestingly, there was a positive correlation between the total number of CD19(+) cells prior to vaccination and seroconversion (p=0.01) and an inverse correlation for IFN-γ responses (p=0.05). Variables not associated with vaccine responses included: pre-vaccine CD4(+) cell counts (total, na?ve or memory), steroid usage at vaccination, age, or conditioning intensity. Time from transplantation to vaccination and absolute CD19(+) cell counts were the strongest predictors of vaccine responses. Methods to improve influenza vaccine responses after allo-HCT are needed.

Copyright ? 2012 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

PMID:
22940056
[PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/22940056
 
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