Spoulou V, Giannaki M, Vounatsou M, Bakoula C, Grafakos S
Department of Pediatrics, Athens University School of Medicine, Greece.
Bone Marrow Transplant. 2004 Jun;33(12):1187-90. doi: 10.1038/sj.bmt.1704476.
Measles, mumps and rubella (MMR) vaccine-induced long-term immunity was studied in 30 children with bone marrow transplants (BMT). Immunity at baseline for MMR was 13.3, 33.3 and 66.6%, respectively. MMR vaccination failed to induce adequate and persistent responses to measles and mumps; seropositivity at 1 and 12 months for measles was 26.6 and 23.3% and for mumps 46.6 and 36.6%, respectively. In contrast, 27 of 30 children with a BMT were immune to rubella 1 month after immunization and retained protective antibody levels at 12 months. The MMR-induced anamnestic responses to rubella among all responders were associated with the production of high avidity antibodies. We conclude that a single dose of MMR given at 2 years after BMT induces suboptimal and short-lived immune responses to measles and mumps; a second dose should be recommended for paediatric BMT recipients.
对30名接受骨髓移植(BMT)的儿童进行了麻疹、腮腺炎和风疹(MMR)疫苗诱导的长期免疫研究。MMR基线免疫率分别为13.3%、33.3%和66.6%。MMR疫苗接种未能诱导出对麻疹和腮腺炎足够且持久的反应;麻疹在1个月和12个月时的血清阳性率分别为26.6%和23.3%,腮腺炎分别为46.6%和36.6%。相比之下,30名接受BMT的儿童中有27名在免疫后1个月对风疹免疫,并在12个月时保持保护性抗体水平。所有有反应者中MMR诱导的对风疹的回忆反应与高亲和力抗体的产生有关。我们得出结论,BMT后2年接种一剂MMR对麻疹和腮腺炎诱导的免疫反应不理想且持续时间短;建议儿科BMT接受者接种第二剂。