Department of Social Pediatrics, Institutes of Child Health, Istanbul University, Istanbul, Turkey.
Institute of Health Science, Istanbul University, Istanbul, Turkey.
J Pediatr Hematol Oncol. 2023 Apr 1;45(3):e370-e377. doi: 10.1097/MPH.0000000000002535. Epub 2022 Aug 30.
Despite developing consensus guidelines addressing immunization after hematopoietic stem cell transplantation (HSCT), studies showed deviations from recommended immunization practices commonly occur. Difference between the ideal scenario presented in guidelines and real-life scenarios is one of the most recognized barriers to implementing recommended practices. Therefore, this study aimed to evaluate pediatric allogeneic HSCT recipients' adherence to revaccination schedule and evaluate the serological status after immunization. Transplant and vaccination records of children who were followed up at least 2 years after HSCT, postvaccination antibody results of vaccine-preventable diseases were evaluated retrospectively. Total of 173 patients have enrolled in this study. Median revaccination onset time was post-transplant 15 months. Adherence to revaccination program was 30% for inactive and 11.4% for live vaccines. Oral polio vaccine was given to 22 patients, and Bacille-Calmette-Guerin vaccine was applied to 3. Seropositivity after revaccination was >90% for Hepatitis B, Hepatitis A, pertussis, and measles, and it was 88.5% for rubella, 80% for mumps and varicella. Measles seropositivity was low in children with hemoglobinopathy. In subgroup assessments of pertussis, patients vaccinated with low antigen-containing pertussis vaccine (Tdap) had higher seropositivity of adenylate cyclase toxin. Our findings revealed the importance of careful monitoring of current practices in pediatric HSCT recipients.
尽管针对造血干细胞移植（HSCT）后免疫接种制定了共识指南，但研究表明，推荐的免疫接种实践经常存在偏差。指南中呈现的理想情况与实际情况之间的差异是实施推荐实践的最公认障碍之一。因此，本研究旨在评估儿科异基因 HSCT 受者对再接种时间表的依从性，并评估免疫接种后的血清学状态。回顾性评估了在 HSCT 后至少随访 2 年的儿童的移植和疫苗接种记录，以及疫苗可预防疾病的疫苗接种后抗体结果。本研究共纳入 173 例患者。中位数再接种起始时间为移植后 15 个月。对灭活疫苗和活疫苗的再接种计划的依从率分别为 30%和 11.4%。22 例患者给予口服脊髓灰质炎疫苗，3 例患者给予卡介苗。乙型肝炎、甲型肝炎、百日咳和麻疹的再接种后血清阳性率>90%，风疹为 88.5%，腮腺炎为 80%，水痘为 80%。血红蛋白病患儿麻疹血清阳性率较低。在百日咳的亚组评估中，接种低抗原含量百日咳疫苗（Tdap）的患者腺昔酸环化酶毒素的血清阳性率更高。我们的研究结果表明，在儿科 HSCT 受者中，仔细监测当前实践的重要性。
