Serological response to vaccination after autologous transplantation for multiple myeloma is associated with improved progression-free and overall survival

Revaccination after autologous hematopoietic cell transplantation (AHCT) is recommended in post-HCT survivorship guidelines to restore humoral immunity. Data on seroconversion after AHCT and vaccination in multiple myeloma (MM) patients are limited. We investigated the feasibility and effectiveness...

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Hauptverfasser: Merz, Almuth (VerfasserIn) , Merz, Maximilian (VerfasserIn) , Zhang, Yali (VerfasserIn) , Stecklein, Kathryn (VerfasserIn) , Pleskow, Jordan (VerfasserIn) , Chen, George L. (VerfasserIn) , Buck, Dennis A. (VerfasserIn) , Mohammadpour, Hemn (VerfasserIn) , Herr, Megan M. (VerfasserIn) , Elshoury, Amro (VerfasserIn) , Hillengaß, Jens (VerfasserIn) , McCarthy, Philip L. (VerfasserIn) , Hahn, Theresa (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2021
In: Transplantation and cellular therapy
Year: 2020, Jahrgang: 27, Heft: 3, Pages: 245.e1-245.e8
ISSN:2666-6367
DOI:10.1016/j.jtct.2020.11.009
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.jtct.2020.11.009
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S266663672030035X
Volltext
Verfasserangaben:Almuth M.A. Merz, Maximilian Merz, Yali Zhang, Kathryn Stecklein, Jordan Pleskow, George L. Chen, Dennis A. Buck, Hemn Mohammadpour, Megan M. Herr, Amro Elshoury, Jens Hillengass, Philip L. McCarthy, Theresa Hahn

MARC

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520 |a Revaccination after autologous hematopoietic cell transplantation (AHCT) is recommended in post-HCT survivorship guidelines to restore humoral immunity. Data on seroconversion after AHCT and vaccination in multiple myeloma (MM) patients are limited. We investigated the feasibility and effectiveness of vaccination post-AHCT and analyzed the restoration of humoral immunity and patient prognosis. Anti-pathogen titers were measured within a median of 2 days before and 96 days after AHCT and following revaccination in 139 MM patients who had a first AHCT from 2013 to 2016. Most (84%) patients received at least one dose of any planned vaccines. High-dose melphalan with AHCT restored measurable immunity in 18% of patients. In an additional >60% of patients, seroconversion occurred after vaccination; however, despite vaccination, 20% of patients remained seronegative for most pathogens. Attainment of MM complete response post-AHCT was associated with higher rates of seroconversion which yielded significantly longer progression-free and overall survival. Our study demonstrates the feasibility of post-AHCT vaccination, supporting measurement of post-vaccination titers to determine which patients should be considered for antimicrobial prophylaxis, as seroconversion does not occur in all patients. Titer seroconversion is a potential indicator of the immunological effects of AHCT, with restoration of humoral immunity demonstrating improved survival. 
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650 4 |a Autologous stem cell transplantation 
650 4 |a Immunoparesis 
650 4 |a Multiple myeloma 
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