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Association of host factors with antibody response to seasonal influenza vaccination in allogeneic hematopoietic stem cell transplant (HSCT) patients
The Journal of Infectious Diseases ( IF 5.0 ) Pub Date : 2021-07-28 , DOI: 10.1093/infdis/jiab391
Janina Linnik 1, 2, 3 , Mohammedyaseen Syedbasha 3 , Hans-Michael Kaltenbach 1, 2 , Dominik Vogt 3 , Yvonne Hollenstein 3 , Lukas Kaufmann 3 , Nathan Cantoni 4 , Sabine Ruosch-Girsberger 5 , Antonia M S Müller 6 , Urs Schanz 6 , Thomas Pabst 7 , Georg Stüssi 8 , Maja Weisser 9 , Jörg Halter 10 , Jörg Stelling 1, 2 , Adrian Egli 3, 11
Affiliation  

Background Influenza vaccination efficacy is reduced after hematopoietic stem cell transplantation (HSCT) and patient factors determining vaccination outcomes are still poorly understood. Methods We investigated the antibody response to seasonal influenza vaccination in 135 HSCT patients and 69 healthy volunteers (HVs) in a prospective observational multicenter cohort study. We identified patient factors associated with hemagglutination inhibition titers against A/California/2009/H1N1, A/Texas/2012/H3N2, and B/Massachusetts/2012 by multivariable regression on the observed titer levels and on seroconversion/seroprotection categories for comparison. Results Both regression approaches yield consistent results but regression on titers estimated associations with higher precision. HSCT patients required two vaccine doses to achieve average responses comparable to a single dose in HVs. Pre-vaccination titers were positively associated with time after transplantation, confirming that HSCT patients can elicit potent antibody responses. However, an unrelated donor, absolute lymphocyte counts below the normal range and treatment with calcineurin inhibitors lower the odds of responding. Conclusions HSCT patients show a highly heterogeneous vaccine response, but overall, patients benefited from the booster shot and can acquire seroprotective antibodies over the years after transplantation. Several common patient factors lower the odds of responding, urging to identify additional preventive strategies in the poorly responding groups.

中文翻译:

宿主因素与异基因造血干细胞移植(HSCT)患者季节性流感疫苗抗体反应的关联

背景 造血干细胞移植 (HSCT) 后流感疫苗接种的效力降低,而决定疫苗接种结果的患者因素仍然知之甚少。方法 我们在一项前瞻性观察性多中心队列研究中调查了 135 名 HSCT 患者和 69 名健康志愿者 (HV) 对季节性流感疫苗接种的抗体反应。我们通过对观察到的滴度水平和血清转换/血清保护类别进行多变量回归来确定与 A/California/2009/H1N1、A/Texas/2012/H3N2 和 B/Massachusetts/2012 的血凝抑制滴度相关的患者因素,以进行比较。结果 两种回归方法都产生一致的结果,但对滴度的回归估计关联具有更高的精度。HSCT 患者需要两次疫苗剂量才能达到与 HV 单剂量相当的平均反应。接种前滴度与移植后时间呈正相关,证实 HSCT 患者可以引发有效的抗体反应。然而,不相关的供体、绝对淋巴细胞计数低于正常范围和使用钙调磷酸酶抑制剂治疗会降低反应的几率。结论 HSCT 患者表现出高度异质的疫苗反应,但总体而言,患者从加强注射中受益,并且可以在移植后多年获得血清保护性抗体。一些常见的患者因素降低了反应的几率,敦促在反应不佳的群体中确定额外的预防策略。接种前滴度与移植后时间呈正相关,证实 HSCT 患者可以引发有效的抗体反应。然而,不相关的供体、绝对淋巴细胞计数低于正常范围和使用钙调磷酸酶抑制剂治疗会降低反应的几率。结论 HSCT 患者表现出高度异质的疫苗反应,但总体而言,患者从加强注射中受益,并且可以在移植后多年获得血清保护性抗体。一些常见的患者因素降低了反应的几率,敦促在反应不佳的群体中确定额外的预防策略。接种前滴度与移植后时间呈正相关,证实 HSCT 患者可以引发有效的抗体反应。然而,不相关的供体、绝对淋巴细胞计数低于正常范围和使用钙调磷酸酶抑制剂治疗会降低反应的几率。结论 HSCT 患者表现出高度异质的疫苗反应,但总体而言,患者从加强注射中受益,并且可以在移植后多年获得血清保护性抗体。一些常见的患者因素降低了反应的几率,敦促在反应不佳的群体中确定额外的预防策略。绝对淋巴细胞计数低于正常范围和使用钙调神经磷酸酶抑制剂治疗会降低反应几率。结论 HSCT 患者表现出高度异质的疫苗反应,但总体而言,患者从加强注射中受益,并且可以在移植后多年获得血清保护性抗体。一些常见的患者因素降低了反应的几率,敦促在反应不佳的群体中确定额外的预防策略。绝对淋巴细胞计数低于正常范围和使用钙调神经磷酸酶抑制剂治疗会降低反应几率。结论 HSCT 患者表现出高度异质的疫苗反应,但总体而言,患者从加强注射中受益,并且可以在移植后多年获得血清保护性抗体。一些常见的患者因素降低了反应的几率,敦促在反应不佳的群体中确定额外的预防策略。
更新日期:2021-07-28
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