Skip to main content

Advertisement

SpringerLink
Log in

Serological response to influenza vaccine after hematopoetic stem cell transplantation

  • Original Article
  • Published:
Annals of Hematology Aims and scope Submit manuscript

Abstract

Vaccination is the best strategy to prevent influenza infection that is a potential cause of morbidity and mortality in immunosuppressed patients. Here, we evaluated the factors that may affect serological response to influenza vaccine in patients who have undergone hematopoetic stem cell transplantation (HSCT). Sixty-one HSCT recipients were included in the study during the 2007–2008 influenza season. Serum samples prior to vaccination and 6–10 weeks after vaccination were collected. Samples were assayed for antibodies to influenza virus A/H1N1, A/H3N2, and B strains by hemagglutination-inhibition assay. The patients were followed in terms of clinical symptoms up to the next influenza season and for adverse effects within a month after vaccination. Overall, pre-vaccine seroprotection rate against all vaccine antigens (A/H1N1, A/H3N2, and B antigens) was 45.1%, post-vaccine seroprotection rate 91% and seroconversion rate was 28.3%. Seroconversion rates were found to be low against B in patients who were vaccinated in the late influenza season (p = 0.018; respectively). Five patients (10.9%) had no immune response against H1N1. Adverse events were reported in 19.6% (n = 9/46) of the patients. In conclusion, the patients should be vaccinated as early as possible in the influenza season, before they are exposed to the virus.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ljungman P, Ward KN, Crooks BN, Parker A, Martino R, Shaw PJ et al (2001) Respiratory virus infections after stem cell transplantation: a prospective study from the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 28:479–484

    Article  CAS  PubMed  Google Scholar 

  2. Ljungman P, Avetisyan G (2008) Influenza vaccination in hematopoietic SCT recipients. Bone Marrow Transplant 42:637–641

    Article  CAS  PubMed  Google Scholar 

  3. Machado CM, Cardoso MRA, da Rocha IF, Boas LSV, Dulley FL (2005) The benefit of influenza vaccination after bone marrow transplantation. Bone Marrow Transplant 36:897–900

    Article  CAS  PubMed  Google Scholar 

  4. Raboni SM, Nogueira MB, Tsuchiya LR, Takahashi GA, Pereira LA, Pasquini R, Siqueira MM (2003) Respiratory tract viral infections in bone marrow transplant patients. Transplantation 76:142–146

    Article  PubMed  Google Scholar 

  5. Nichols WG, Guthrie KA, Corey L, Boeckh M (2004) Influenza infections after hematopoietic stem cell transplantation: risk factors, mortality, and the effect of antiviral therapy. Clin Infect Dis 39:1300–1306

    Article  PubMed  Google Scholar 

  6. Whimbey E, Elting LS, Couch RB, Lo W, Williams L, Champlin RE, Bodey GP (1994) Influenza A virus infections among hospitalized adult bone marrow transplant recipients. Bone Marrow Transplant 13:437–440

    CAS  PubMed  Google Scholar 

  7. Bowden RA (1997) Respiratory virus infections after marrow transplant: The Fred Hutchinson Cancer Research Center Experience. Am J Med 102:27–30

    Article  CAS  PubMed  Google Scholar 

  8. Cough RB, Englund JA, Whimbley E (1997) Respiratory viral infections in immunocompetent and immunocompromised persons. Am J Med 102:2–9

    Google Scholar 

  9. Scott JD, Englund JA, Myerson D, Geballe AP (2004) Influenza a pneumonia presenting as progressive focal infiltrates in a stem cell transplant recipient. J Clin Virol 31:96–99

    Article  PubMed  Google Scholar 

  10. Fiore AE, Shay DK, Broder K, Iskander JK, Uyeki TM, Mootrey G et al (2008) Centers for Disease Control and Prevention (CDC); Advisory Committee on Immunization Practices (ACIP). Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP) 2008. MMWR Recomm Rep 57:1–60

    PubMed  Google Scholar 

  11. Van Essen GA, Palache AM, Forleo E, Fedson DS (2003) Influenza vaccination in 2000: recommendations and vaccine use in 50 developed and rapidly developing countries. Vaccine 21:1780–1785

    Article  PubMed  Google Scholar 

  12. Ljungman P, Engelhard D, de la Camara R, Einsele H, Locasciulli A, Martino R et al (2005) Vaccination of stem cell transplant recipients: recommendations of the Infectious Diseases Working Party of the EBMT. Bone Marrow Transplant 35:737–746

    Article  CAS  PubMed  Google Scholar 

  13. Machado CM (2004) Reimmunization after bone marrow transplantation-current recommendations and perspectives. Braz J Med Biol Res 37:151–158

    CAS  PubMed  Google Scholar 

  14. Zimmerman RK, Middleton DB (2007) Vaccines for persons at high risk. J Fam Pract 56(2):S38–S46

    PubMed  Google Scholar 

  15. Wilck MB, Baden LR (2008) Vaccination after stem cell transplant: a review of recent developments and implications for current practice. Curr Opin Infect Dis 21:399–408

    Article  PubMed  Google Scholar 

  16. Avetisyan G, Aschan J, Hassan M, Ljungman P (2008) Evaluation of immune responses to seasonal influenza vaccination in healthy volunteers and in patients after stem cell transplantation. Transplantation 86:257–263

    Article  CAS  PubMed  Google Scholar 

  17. www.cdc.gov/flu/weekly/fluactivity.htm

  18. Pauksen K, Linde A, Hammarström V, Sjölin J, Carneskog J, Jonsson G, Oberga G, Engelmann H, Ljungman P (2000) Granulocyte-macrophage colony-stimulating factor as immunomodulating factor together with influenza vaccination in stem cell transplant patients. Clin Infect Dis 30:342–348, Erratum in: Clin Infect Dis 2000; 30: 992

    Article  CAS  PubMed  Google Scholar 

  19. Morecki S, Gelfand Y, Nagler A, Or R, Naparstek E, Varadi G, Engelhard D, Akerstein A, Slavin S (2001) Immune reconstitution following allogeneic stem cell transplantation in recipients conditioned by low intensity vs myeloablative regimen. Bone Marrow Transplant 28:243–249

    Article  CAS  PubMed  Google Scholar 

  20. Ring A, Marx G, Steer C, Harper P (2002) Influenza vaccination and chemotherapy: a shot in the dark? Support Care Cancer 10:462–465

    Article  PubMed  Google Scholar 

  21. Engelhard D, Nagler A, Hardan I, Morag A, Aker M, Baciu H et al (1993) Antibody response to a two-dose regimen of influenza vaccine in allogeneic T cell depleted and autologous BMT recipients. Bone Marrow Transplant 11:1–5

    CAS  PubMed  Google Scholar 

  22. Maris M, Boeckh M, Storer B, Dawson M, White K, Keng M, Sandmaier B, Maloney D, Storb R, Storek J (2003) Immunologic recovery after hematopoietic cell transplantation with nonmyeloablative conditioning. Exp Hematol 31:941–952

    Article  CAS  PubMed  Google Scholar 

  23. Gandhi MK, Egner W, Sizer L, Inman I, Zambon M, Craig JI, Marcus RE (2001) Antibody responses to vaccinations given within the first two years after transplant are similar between autologous peripheral blood stem cell and bone marrow transplant recipients. Bone Marrow Transplant 28:775–781

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Unit of Social Pediatrics, Department of Pediatrics, Faculty of Medicine, Hacettepe University, 06100, Ankara, Turkey

    S. Songül Yalçın, Meda Kondolot & Kadriye Yurdakök

  2. Virology Unit of Refik Saydam Hıfzıssıha Center, Ankara, Turkey

    Nurhan Albayrak & A. Başak Altaş

  3. Unit of Hematopoetic Stem Cell Transplantation, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    Yasemin Karacan, Salih Aksu & Hakan Göker

  4. Unit of Hematopoetic Stem Cell Transplantation, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    Barış Kuşkonmaz, Mualla Çetin & Duygu Uçkan

Authors
  1. S. Songül Yalçın
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Meda Kondolot
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nurhan Albayrak
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Başak Altaş
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yasemin Karacan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Barış Kuşkonmaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Salih Aksu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mualla Çetin
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hakan Göker
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Kadriye Yurdakök
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Duygu Uçkan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Songül Yalçın.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yalçın, S.S., Kondolot, M., Albayrak, N. et al. Serological response to influenza vaccine after hematopoetic stem cell transplantation. Ann Hematol 89, 913–918 (2010). https://doi.org/10.1007/s00277-009-0897-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00277-009-0897-1

Keywords

Search

Navigation