, 2010,XIV,1; 42-52

Safety and efficacy of vaccination in children after stem cell transplantation. Part I

Jolanta Goździk1,2, Hanna Czajka3, Szymon Skoczeń1,2, Jarosław Baran4, Wojciech Czogała1,2, Izabela Tarczoń3, Aleksandra Krasowska-Kwiecień1,2, Anna Wędrychowicz1,2, Oktawiusz Wiecha1


1Ośrodek Transplantacji Uniwersyteckiego Szpitala Dziecięcego w Krakowie
Kierownik: dr n. med. J. Goździk


2Zakład Transplantologii Katedry Immunologii Klinicznej i Transplantologii CM-UJ w Krakowie
Kierownik: dr hab. med. M. Majka


3Poradnia Pediatryczna Szczepień dla dzieci z Grup Wysokiego Ryzyka
przy Wojewódzkim Specjalistycznym Szpitalu Dziecięcym im. św. Ludwika w Krakowie
Kierownik: dr n. med. H. Czajka


4Zakład Immunologii Klinicznej Katedry Immunologii klinicznej i Transplantologii CM-UJ w Krakowie
Kierownik: prof. dr hab. med. M. Zembala

  • Fig. 1. Time between transplantation after stem cell transplantation and beginning of vaccination protocol
  • Fig. 2. Vaccines used in the protocol
  • Table I. Age of patients
  • Table II. Vaccination protocol for recipients of autologous hematopietic stem cell transplantation
  • Table III. Vaccination protocol for recepients of allogeneic hematopietic stem cell transplantation
  • Table IV. Reference values used in our Centre for tested antibodies
  • Table V. Results of assessment of immune system before revaccination
  • Table VI. Plasma IgG concentrations against common pathogens before and after vaccinations
  • Table VII. The analysis of plasma IgG concentrations against common pathogens before and after vaccinations

The aim of the study was the evaluation of safety and efficacy vaccination in children after stem cell transplantation.

Patients and methods: 21 patients, 1.4-22 (average 7.8) years old, 13 boys and 8 girls after autologous (11-52%) and allogeneic (10-48%) transplantation were included in the vaccination protocol. Indications for transplantation were: neoplastic disease – 16, immunodeficiencies – 3 and aplastic anaemia 2 cases. Time between transplantation and beginning of vaccination protocol was 0.8-4 (average 1.5) years. Vaccination protocol was constructed on the basis of the European Group for Blood and Marrow Transplantation indications. We have evaluated: 1) quality of recipient immune reconstitution and protection against common pathogens 2) immunogenicity of revaccination schedule; 3) safety of the vaccination programme.

Results: With the exception of one patient presenting with repeated fever, lymph node enlargement, muscle and joint pain, no important side effects were observed. Meningococcial meningitis developed in one patient who refused vaccination. The mean concentrations of antibodies in the plasma before and after vaccination were as follows: anti-diphteria (54; 2285), anti-tetanus (136; 3149) and anti-hepatitis B virus (anti-HBs: 24; 474) IU/ml.

Conclusions: 1. Vaccination in patients after transplantation is efficient and well tolerated. 2. Significant increase of antibody level was detected. 3. Any delay in beginning the vaccination can result in life threatening complications.

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