International Journal of Hematology

DOI: 10.1007/s12185-016-2163-3 Pages: 638-645

Serum IgM levels independently predict immune response to influenza vaccine in long-term survivors vaccinated at >1 year after undergoing allogeneic hematopoietic stem cell transplantation

1. Hamamatsu University School of Medicine, Division of Hematology, Internal Medicine 3

Correspondence to:
Takaaki Ono
Tel: +81-53-435-2267
Email: takaono@hama-med.ac.jp

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Abstract

Influenza virus infection can cause fatal complications (e.g., pneumonia) in immunodeficient long-term survivors of allogeneic hematopoietic stem cell transplantation (allo-HSCT). The immune response to the vaccine improves if it is administered at >1 year after allo-HSCT, although the response may vary according to the patient’s immune status. We sought to identify predictors of immune response to trivalent inactivated influenza vaccine (TIV) among patients vaccinated at >1 year after allo-HSCT. We included 27 allo-HSCT recipients, with a median interval of 4.3 years (range 1.0–10.1 years) from transplantation to vaccination. Nineteen patients achieved a response to TIV, although a low immune response to TIV was significantly associated with calcineurin inhibitor treatment, and moderate chronic graft-versus-host disease and IgM levels of <0.5 g/L at the time of vaccination. Multivariate analysis revealed that IgM levels of <0.5 g/L at the vaccination were an independent predictor of a low immune response to TIV. These results indicate that a more effective approach is needed to induce a vaccine-specific immune response among long-term survivors of allo-HSCT who have low serum IgM levels.

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