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异基因造血干细胞移植后成人患者对麻疹、腮腺炎、风疹和水痘带状疱疹的免疫分析:单中心经验。

Analysis of Immunity against Measles, Mumps, Rubella, and Varicella Zoster in Adult Recipients of Allogeneic Hematopoietic Stem Cell Transplantation: A Single-Center Experience.

机构信息

Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.

Division of Transfusion, Okayama University Hospital.

出版信息

Acta Med Okayama. 2022 Jun;76(3):247-253. doi: 10.18926/AMO/63718.

Abstract

Vaccine-preventable disease (VPD) infections are more severe in immunocompromised hosts. Vaccination against measles, mumps, rubella, and varicella zoster (VZV) (MMRV) is therefore recommended for hematopoietic stem cell transplantation (HCT) recipients. However, studies on adult HCT recipients with VPD infections are limited. At our institution, we have systematically conducted serological MMRV tests as a part of check-up examinations during long-term follow-up (LTFU) after HCT since 2015. This retrospective study aimed to evaluate changes in the serostatus between before and 2 years after allogeneic HCT. Among 161 patients, the pre-transplant seropositivity was 82.7% for measles, 86.8% for mumps, 84.2% for rubella, and 94.3% for VZV. Among 56 patients who underwent LTFU including serological MMRV tests at 2 years after HCT, the percentages maintaining seroprotective antibody levels for measles, mumps, rubella and VZV were 71.5% (40/56), 51.8% (29/56), 48.2% (27/56), and 60.7% (34/56), respectively. Vaccination was recommended for 22 patients, and 12 were vaccinated. Among the 12 vaccinated patients, rates of seroconversion were examined in 2-6 patients for each of the four viruses. They were 100% (3/3) for measles, 33.3% (1/3) for mumps, 50% (3/6) for rubella, and 0% (0/2) for VZV. Further studies are warranted to clarify the effect of vaccination in adult HCT recipients.

摘要

疫苗可预防疾病(VPD)在免疫功能低下宿主中更为严重。因此,建议造血干细胞移植(HCT)受者接种麻疹、腮腺炎、风疹和水痘带状疱疹(MMRV)疫苗。然而,针对 VPD 感染的成年 HCT 受者的研究有限。在我们的机构中,自 2015 年以来,我们已经系统地进行了血清学 MMRV 检测,作为 HCT 后长期随访(LTFU)期间检查的一部分。这项回顾性研究旨在评估异基因 HCT 前后 2 年的血清学状态变化。在 161 例患者中,移植前麻疹、腮腺炎、风疹和水痘带状疱疹的血清阳性率分别为 82.7%、86.8%、84.2%和 94.3%。在 56 例接受 LTFU 包括 HCT 后 2 年血清学 MMRV 检测的患者中,麻疹、腮腺炎、风疹和水痘带状疱疹保持血清保护性抗体水平的百分比分别为 71.5%(40/56)、51.8%(29/56)、48.2%(27/56)和 60.7%(34/56)。建议为 22 例患者接种疫苗,其中 12 例接种了疫苗。在 12 例接种疫苗的患者中,对每例患者的四种病毒进行了 2-6 次血清转化率检查。麻疹为 100%(3/3),腮腺炎为 33.3%(1/3),风疹为 50%(3/6),水痘带状疱疹为 0%(0/2)。需要进一步研究来阐明疫苗接种对成年 HCT 受者的影响。

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