Comparable humoral response after two doses of adjuvanted influenza A/H1N1pdm2009vaccine or natural infection in allogeneic stem cell transplant recipients

Dhédin N, Krivine A, Le Corre Nicole, Mallet Alain, Lioure Bruno, Bay JO, Rubio MT, Agape P, Thiébaut A, Le Goff J, Autran B and Ribaud P


BACKGROUND: The present study evaluated immunogenicity and tolerance of two-dose influenza A/H1N1pdm09 vaccination in allogeneic hematopoietic stem cell transplantation (HSCT) recipients, and compared the vaccine-induced humoral response to that triggered by natural infection in another group of HSCT patients. METHODS: Adult allogeneic HSCT recipients vaccinated with two doses of influenza A/H1N1pdm09 vaccine, separated by 3 weeks, and patients with proven influenza A/H1N1pdm09 infection were included. Antibody responses were measured by hemagglutination-inhibition assay 1) on days 0, 21, 42 and 6 months after the first vaccine injection in vaccinated patients and 2) before pandemic and after influenza A/H1N1pdm09 infection, in patients presented natural infection. RESULTS: At baseline, 3% of 59 recipients of adjuvanted vaccine and 0% of 20 infected patients were seroprotected (antibody titer≥1/40). Seroprotection rate observed 42 days after vaccination was not different from that observed after natural infection (66% and 60% respectively, p=0.78). In vaccinated patients, seroprotection rate increased significantly from 54% to 66% between day 21 and 42 (p=0.015). Moreover, after 6 months, seroprotection rate in 21 vaccinated patients was similar to that observed in 10 infected patients evaluated at least 76 days after infection (D76-217) (60% and 81% respectively, p=0.2). In multivariate analysis, no immunosuppressive treatment or chronic graft-versus-host disease (GVHD) and longer time between transplantation and vaccination/infection were associated with a stronger humoral response. The adjuvanted vaccine was safe with low rate of GVHD worsening. CONCLUSION: In HSCT recipients, two doses of influenza A/H1N1pdm09 adjuvanted vaccine were safe and induced a humoral response comparable to that triggered by natural infection in these patients

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Título de la Revista: VACCINE
Volumen: 32
Número: 5
Fecha de publicación: 2014
Página de inicio: 585
Página final: 91