Engelhard D, Handsher R, Naparstek E, Hardan I, Strauss N, Aker M, Or R, Baciu H, Slavin S
Department of Pediatrics, Hadassah University Hospital, Jerusalem, Israel.
Bone Marrow Transplant. 1991 Oct;8(4):295-300.
Following a small outbreak of poliomyelitis which occurred in the summer of 1988 in Israel, two sequential doses of inactivated polio vaccine (IPV) were administered to 42 bone marrow transplant (BMT) recipients (aged 2-50 years) who were 6-96 months (median 16 months) after transplantation. Prior to vaccination, only 68-80% patients (n = 42) had protective (greater than or equal to 4) antibody levels against the three serotypes of poliovirus, compared with 92-96% (n = 25) before BMT (p = 0.02 for types 1 and 3). After the second dose of IPV, 89-98% (n = 27) of the recipients had protective antibody levels. The pre-vaccination antibody titers were lower than before BMT (p = 0.006, 0.0007 and 0.0008 for types 1,2 and 3, respectively). After the first dose of IPV, antibody titers rose in the 42 patients (p = 0.002, 0.043 and 0.002 for types 1, 2 and 3, respectively) and following the second dose, a further increase in antibody levels was noted. Regression analysis revealed that graft-versus-host disease, pre-BMT polio antibody titers, age and type of transplantation (allogeneic versus autologous) were significant explanatory variables for the specific antibody levels, while the time lapse between BMT and vaccination, and primary disease proved of no significance. Vaccination against poliovirus after BMT is advocated, as it reinstates and raises the lost specific humoral immunity.
1988年夏季以色列发生了小儿麻痹症小规模疫情后，对42名骨髓移植（BMT）受者（年龄在2至50岁之间）接种了两剂灭活脊髓灰质炎疫苗（IPV），这些受者在移植后6至96个月（中位数为16个月）。接种疫苗前，只有68 - 80%的患者（n = 42）对三种脊髓灰质炎病毒血清型具有保护性（大于或等于4）抗体水平，而移植前这一比例为92 - 96%（n = 25）（1型和3型p = 0.02）。接种第二剂IPV后，89 - 98%的受者（n = 27）具有保护性抗体水平。接种疫苗前的抗体滴度低于移植前（1型、2型和3型分别为p = 0.006、0.0007和0.0008）。接种第一剂IPV后，42名患者的抗体滴度上升（1型、2型和3型分别为p = 0.002、0.043和0.002），接种第二剂后，抗体水平进一步升高。回归分析显示，移植物抗宿主病、移植前脊髓灰质炎抗体滴度、年龄和移植类型（同种异体与自体）是特定抗体水平的显著解释变量，而移植与接种疫苗之间的时间间隔以及原发疾病则无显著意义。提倡在骨髓移植后接种脊髓灰质炎病毒疫苗，因为它能恢复并提高丧失的特异性体液免疫。
