Association of Host Factors With Antibody Response to Seasonal Influenza Vaccination in Allogeneic Hematopoietic Stem Cell Transplant Patients
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Date
2022-04-15
Publication Type
Journal Article
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yes
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Abstract
Background
Influenza vaccination efficacy is reduced after hematopoietic stem cell transplantation (HSCT) and patient factors determining vaccination outcomes are still poorly understood.
Methods
We investigated the antibody response to seasonal influenza vaccination in 135 HSCT patients and 69 healthy volunteers (HVs) in a prospective observational multicenter cohort study. We identified patient factors associated with hemagglutination inhibition titers against A/California/2009/H1N1, A/Texas/2012/H3N2, and B/Massachusetts/2012 by multivariable regression on the observed titer levels and on seroconversion/seroprotection categories for comparison.
Results
Both regression approaches yielded consistent results but regression on titers estimated associations with higher precision. HSCT patients required 2 vaccine doses to achieve average responses comparable to a single dose in HVs. Prevaccination titers were positively associated with time after transplantation, confirming that HSCT patients can elicit potent antibody responses. However, an unrelated donor, absolute lymphocyte counts below the normal range, and treatment with calcineurin inhibitors lowered the odds of responding.
Conclusions
HSCT patients show a highly heterogeneous vaccine response but, overall, patients benefited from the booster shot and can acquire seroprotective antibodies over the years after transplantation. Several common patient factors lower the odds of responding, urging identification of additional preventive strategies in the poorly responding groups.
Clinical Trials Registration
NCT03467074.
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Publication status
published
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Book title
Journal / series
Volume
225 (8)
Pages / Article No.
1482 - 1493
Publisher
Oxford University Press
Event
Edition / version
Methods
Software
Geographic location
Date collected
Date created
Subject
influenza; vaccination; Hematopoietic stem cell transplantation; immunosuppression; graft-versus-host disease; hemagglutination inhibition titer; seroconversion; categorical regression; sequential model
Organisational unit
03699 - Stelling, Jörg / Stelling, Jörg
Notes
This paper was presented in part at the 31. Conference of the Austro-Swiss Region of the International Biometric Society in Lausanne, Switzerland from 9-12. September 2019.