Casale Maddalena, Di Maio Nicoletta, Verde Valentina, Scianguetta Saverio, Di Girolamo Maria Grazia, Tomeo Rita, Roberti Domenico, Misso Saverio, Perrotta Silverio
Department of Women, Child and General and Specialized Surgery, University "Luigi Vanvitelli", 80138 Naples, Italy.
Immuno-Transfusion Service, ASL Caserta, 81031 Aversa, Italy.
Vaccines (Basel). 2021 May 27;9(6):561. doi: 10.3390/vaccines9060561.
Measles, mumps and rubella (MMR) still determine significant morbidity and mortality, although a highly effective vaccine is available. Postponing the MMR vaccination until 6 months after the last red blood cell (RBC) transfusion is recommended, but this delay is incompatible with chronic transfusions. The present study aimed at investigating the impact of blood transfusions on the immunogenicity of the MMR vaccine. In this observational study, a group of 45 transfusion- dependent (TD) patients was compared to 24 non-transfusion-dependent (NTD) patients. Immunity to measles was achieved in 35 (78%) TD and 21 (88%) NTD subjects (p = 0.7), to mumps in 36 (80%) TD and 21 (88%) NTD subjects (p = 0.99), and to rubella in 40 (89%) TD and 23 (96%) NTD subjects (p = 0.99). No significant difference was observed in the number of non-immune individuals or those with doubtful protection between the two groups ( > 0.05). The mean IgG value, assayed in 50 pre-storage leukoreduced RBC units, was 0.075 ± 0.064 mg/mL, ten times lower than the level assumed in blood units and considered detrimental to the immune response in TD patients. This work shows a favorable response to MMR vaccination in TD and NTDT patients and paves the way for further larger studies assessing the impact of chronic transfusions on vaccine response.
尽管已有高效疫苗，但麻疹、腮腺炎和风疹（MMR）仍会导致显著的发病和死亡。建议将MMR疫苗接种推迟到最后一次红细胞（RBC）输血后6个月，但这种延迟与慢性输血不相容。本研究旨在调查输血对MMR疫苗免疫原性的影响。在这项观察性研究中，将一组45名依赖输血（TD）的患者与24名非依赖输血（NTD）的患者进行了比较。35名（78%）TD患者和21名（88%）NTD患者对麻疹产生了免疫力（p = 0.7），36名（80%）TD患者和21名（88%）NTD患者对腮腺炎产生了免疫力（p = 0.99），40名（89%）TD患者和23名（96%）NTD患者对风疹产生了免疫力（p = 0.99）。两组之间非免疫个体或保护情况存疑的个体数量没有显著差异（> 0.05）。在50个储存前白细胞滤除的RBC单位中检测的平均IgG值为0.075±0.064 mg/mL，比血液单位中假定的水平低10倍，该水平被认为对TD患者的免疫反应有害。这项工作表明TD和NTDT患者对MMR疫苗接种有良好反应，并为进一步评估慢性输血对疫苗反应影响的更大规模研究铺平了道路。
