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Successful SARS-CoV-2 mRNA Vaccination Program in Allogeneic Hematopoietic Stem Cell Transplant Recipients-A Retrospective Single-Center Analysis.
Nikoloudis, Alexander; Neumann, Ines Julia; Buxhofer-Ausch, Veronika; Machherndl-Spandl, Sigrid; Binder, Michaela; Kaynak, Emine; Milanov, Robert; Nocker, Stefanie; Stiefel, Olga; Strassl, Irene; Wipplinger, Dagmar; Moyses, Margarete; Kerschner, Heidrun; Apfalter, Petra; Girschikofsky, Michael; Petzer, Andreas; Weltermann, Ansgar; Clausen, Johannes.
Afiliación
  • Nikoloudis A; Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz-Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, Austria.
  • Neumann IJ; Medical Faculty, Johannes Kepler University, 4020 Linz, Austria.
  • Buxhofer-Ausch V; Interdisciplinary Center for Infectious Medicine and Microbiology, Linz, Austria.
  • Machherndl-Spandl S; Medical Faculty, Johannes Kepler University, 4020 Linz, Austria.
  • Binder M; Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz-Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, Austria.
  • Kaynak E; Medical Faculty, Johannes Kepler University, 4020 Linz, Austria.
  • Milanov R; Interdisciplinary Center for Infectious Medicine and Microbiology, Linz, Austria.
  • Nocker S; Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz-Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, Austria.
  • Stiefel O; Medical Faculty, Johannes Kepler University, 4020 Linz, Austria.
  • Strassl I; Interdisciplinary Center for Infectious Medicine and Microbiology, Linz, Austria.
  • Wipplinger D; Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz-Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, Austria.
  • Moyses M; Interdisciplinary Center for Infectious Medicine and Microbiology, Linz, Austria.
  • Kerschner H; Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz-Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, Austria.
  • Apfalter P; Interdisciplinary Center for Infectious Medicine and Microbiology, Linz, Austria.
  • Girschikofsky M; Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz-Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, Austria.
  • Petzer A; Interdisciplinary Center for Infectious Medicine and Microbiology, Linz, Austria.
  • Weltermann A; Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz-Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, Austria.
  • Clausen J; Interdisciplinary Center for Infectious Medicine and Microbiology, Linz, Austria.
Vaccines (Basel) ; 11(10)2023 Sep 28.
Article en En | MEDLINE | ID: mdl-37896938
(1) Background: mRNA COVID-19 vaccines are effective but show varied efficacy in immunocompromised patients, including allogeneic hematopoietic stem cell transplant (HSCT) recipients. (2) Methods: A retrospective study on 167 HSCT recipients assessed humoral response to two mRNA vaccine doses, using the manufacturer cut-off of ≥7.1 BAU/mL, and examined factors affecting non-response. (3) Results: Twenty-two percent of HSCT recipients failed humoral response. Non-responders received the first vaccine a median of 10.2 (2.5-88.9) months post-HSCT versus 35.3 (3.0-215.0) months for responders (p < 0.001). Higher CD19 (B cell) counts favored vaccination response (adjusted odds ratio (aOR) 3.3 per 100 B-cells/microliters, p < 0.001), while ongoing mycophenolate mofetil (MMF) immunosuppression hindered it (aOR 0.04, p < 0.001). By multivariable analysis, the time from transplant to first vaccine did not remain a significant risk factor. A total of 92% of non-responders received a third mRNA dose, achieving additional 77% seroconversion. Non-converters mostly received a fourth dose, with an additional 50% success. Overall, a cumulative seroconversion rate of 93% was achieved after up to four doses. (4) Conclusion: mRNA vaccines are promising for HSCT recipients as early as 3 months post-HSCT. A majority seroconverted after four doses. MMF usage and low B cell counts are risk factors for non-response.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Vaccines (Basel) Año: 2023 Tipo del documento: Article País de afiliación: Austria Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Vaccines (Basel) Año: 2023 Tipo del documento: Article País de afiliación: Austria Pais de publicación: Suiza