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急性和慢性移植物抗宿主病对自体或异基因造血干细胞移植后第一年麻疹、腮腺炎、风疹和水痘抗体持久性的影响

Influence of Acute and Chronic Graft-Versus-Host Disease on Persistence of Antibodies against Measles, Mumps, Rubella and Varicella in the First Year after Autologous or Allogeneic Hematopoietic Stem Cell Transplantation.

作者信息

Harrison Nicole, Burgmann Heinz, Rabitsch Werner, Honsig Claudia, Robak Oliver

机构信息

Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, 1090 Vienna, Austria.

Department of Medicine I, Division of Bone Marrow Transplantation, Medical University of Vienna, 1090 Vienna, Austria.

出版信息

Vaccines (Basel). 2023 Mar 14;11(3):656. doi: 10.3390/vaccines11030656.

Abstract

Patients after hematopoietic stem cell transplantation (HSCT) are vulnerable to infections due to severe immunosuppression. Live-attenuated vaccines are contraindicated for two years after HSCT. The aim of this study was to assess the persistence of antibodies against measles, mumps, rubella and varicella in the first year after HSCT. Forty patients undergoing autologous ( 12) or allogeneic ( = 28) HSCT were included in this study. Specific IgG antibodies to measles, mumps, rubella and varicella virus in serum samples were assessed by the LIAISON XL, a fully automated chemiluminescence analyzer, at seven different time points starting one week before HSCT and up to 12 months after HSCT. At baseline, before HSCT, most patients showed antibodies against measles (100%), mumps (80%), rubella (97.5%) and varicella (92.5%). Although titers declined over time, most patients retained antibodies against measles (92.5%), mumps (62.5%), rubella (87.5%) and varicella (85%) up to 12 months after HSCT. There was no significant difference between patients with and without GvHD concerning persistence of antibody titers. Significantly higher varicella titers were detected in autologous patients compared to patients with chronic GvHD. Considering that live-attenuated vaccines should not be administered during the first year after HSCT, the persistence of antibodies against these diseases is relevant.

摘要

造血干细胞移植(HSCT)后的患者由于严重免疫抑制而易发生感染。减毒活疫苗在HSCT后两年内禁忌使用。本研究的目的是评估HSCT后第一年麻疹、腮腺炎、风疹和水痘抗体的持久性。本研究纳入了40例接受自体(12例)或异体(28例)HSCT的患者。通过LIAISON XL全自动化学发光分析仪,在HSCT前一周至HSCT后12个月的七个不同时间点,评估血清样本中针对麻疹、腮腺炎、风疹和水痘病毒的特异性IgG抗体。在基线时,即HSCT前,大多数患者显示出针对麻疹(100%)、腮腺炎(80%)、风疹(97.5%)和水痘(92.5%)的抗体。尽管抗体滴度随时间下降,但大多数患者在HSCT后12个月时仍保留针对麻疹(92.5%)、腮腺炎(62.5%)、风疹(87.5%)和水痘(85%)的抗体。在抗体滴度持久性方面,有或没有移植物抗宿主病(GvHD)的患者之间没有显著差异。与慢性GvHD患者相比,自体患者中检测到的水痘滴度显著更高。考虑到在HSCT后的第一年不应接种减毒活疫苗,这些疾病抗体的持久性具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7733/10052354/00370c5f86cb/vaccines-11-00656-g001.jpg

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