Cordonnier C, Labopin M, Robin C, Ribaud P, Cabanne L, Chadelat C, Cesaro S, Ljungman P
Hematology Department, Henri Mondor Teaching Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) and Paris-Est Créteil University, Créteil, France.
EBMT Data and Study Office, Saint-Antoine Teaching Hospital, AP-HP; and UPMC Paris 6 University, INSERM UMR-S 893 Group 14, Paris Cedex 12, France.
Bone Marrow Transplant. 2015 Jul;50(7):978-83. doi: 10.1038/bmt.2015.42. Epub 2015 Apr 13.
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.
造血干细胞移植（HSCT）受者的免疫接种指南建议，在移植后3至6个月接种三剂抗肺炎球菌结合疫苗（PCV），如果没有移植物抗宿主病（GVHD），则在12个月时接种一剂23价多糖疫苗（PPV23）；如果有GVHD，则接种额外一剂PCV。由于文献中缺乏长期数据，因此不建议在12个月后加强接种。我们的目标是评估按照当前指南在10年前接种疫苗的患者中，肺炎球菌疫苗免疫反应的维持情况。对IDWP01（传染病工作组1）试验的30名存活患者进行了评估，检测其针对PCV7七种抗原以及PPV23两种特异性抗原的抗体水平。与移植后24个月相比，免疫反应没有显著下降，但存在重要的血清型特异性差异。没有证据表明在移植后2至11年给11/30的患者额外接种一剂PPV23有益。在按照当前指南接种过肺炎链球菌疫苗且没有或仅有少量GVHD的长期HSCT存活者中，十年后特异性免疫力并未完全维持。HSCT受者在12个月后抗肺炎球菌疫苗的最佳接种方案仍有待确定。
