Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching Hospital, Hematology Department, and Paris 12 University, 94010 Créteil, France.
Vaccine. 2010 Mar 24;28(15):2730-4. doi: 10.1016/j.vaccine.2010.01.025. Epub 2010 Jan 29.
The current recommendations for active immunization after stem cell transplant (SCT) include 3 doses of 7-valent pneumococcal conjugate vaccine (PCV7) from 3 months after transplant, followed by a 23-valent polysaccharide pneumococcal vaccine (PPV23). However, until now, the immune response to PPV23 after PCV7 has not been assessed after SCT. In the EBMT IDWP01 trial, 101 patients received 1 dose of PPV23 at 12 or 18 months, both after 3 doses of PCV7. The efficacy of PPV23 was assessed 1 month later and at 24 months after transplant by the pneumococcal serotype 1 and 5 antibody levels. Serotype 1 and 5 are not included in PCV7. Although the geometric mean concentrations were significantly higher 1 month after PPV23, for both antigens, the response rates (> or =0.15 microg/mL), in the range of 68-94%, were not different between groups independent of the assessment date. One PPV23 dose after 3 PCV7 doses, already known to increase the response to PCV7, also extends the serotype coverage given 12 or 18 months after transplant.
目前，干细胞移植（SCT）后主动免疫的建议包括 3 剂 7 价肺炎球菌结合疫苗（PCV7），从移植后 3 个月开始，随后是 23 价肺炎球菌多糖疫苗（PPV23）。然而，到目前为止，PCV7 后接种 PPV23 的免疫反应在 SCT 后尚未得到评估。在 EBMT IDWP01 试验中，101 例患者在 3 剂 PCV7 后 12 或 18 个月时接受了 1 剂 PPV23。1 个月后和移植后 24 个月时，通过肺炎球菌血清型 1 和 5 抗体水平评估 PPV23 的疗效。血清型 1 和 5 不包括在 PCV7 中。尽管 1 个月后 PPV23 的几何平均浓度显著升高，但对于这两种抗原，反应率（≥0.15μg/ml），在 68-94%之间，在不同的评估日期之间，两组之间没有差异。3 剂 PCV7 后接种 1 剂 PPV23 ，已知可增加对 PCV7 的反应，也可延长移植后 12 或 18 个月后的血清型覆盖范围。
