Measles immunity after allogeneic stem cell transplantation;: influence of donor type, graft type, intensity of conditioning, and graft-versus host disease
Measles immunity after allogeneic stem cell transplantation;: influence of donor type, graft type, intensity of conditioning, and graft-versus host disease
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DOI：
10.1038/sj.bmt.1704634
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发表时间：
2004-10-01
影响因子：
4.8
通讯作者：
Ringdén, O
中科院分区：
文献类型：
--
作者：
Ljungman, P;Aschan, J;Ringdén, O
在异基因干细胞移植（SCT）后的随访期间，患者经常失去对麻疹等传染性病原体的免疫力。分析不同因素对麻疹免疫的影响。共纳入395例无病生存期至少1年的患者。在SCT后2年，对没有慢性GVHD或持续免疫抑制的儿童和年轻人进行麻疹疫苗接种。总共有264名患者有匹配的同胞供体，131名患者有不匹配的家庭或无关供体。共有318例患者接受了骨髓和77例外周血干细胞。总体而言，375例患者接受了清髓性和20例非清髓性预处理。在395名患者中，133名（34%）对麻疹呈血清阴性。在多变量模型中，年龄较小或接种麻疹疫苗，而不是以前的麻疹疾病，移植前的风险因素成为血清阴性，并有可疑的保护性免疫麻疹。急性GVHD II-IV级是血清阴性的危险因素，造血干细胞是可疑保护性免疫的危险因素。以前接种过麻疹疫苗的儿童和年轻人很容易感染麻疹。由于麻疹在许多国家再次流行，并且麻疹是SCT后的严重感染，因此应考虑接种疫苗。
During follow-up after allogeneic stem cell transplantation (SCT), patients frequently lose their immunity to infectious agents such as measles. The aim of this study was to analyze the influence of different factors on measles immunity. In total, 395 patients with a disease-free survival of at least 1 year were included. Measles vaccination was given at 2 years after SCT to children and young adults without chronic GVHD or ongoing immunosuppression. In all, 264 patients had matched sibling donors and 131 either mismatched family or unrelated donors. Totally, 318 patients received bone marrow and 77 peripheral blood stem cells. Overall, 375 patients had undergone myeloablative and 20 nonmyeloablative conditioning. Out of 395 patients, 133 (34%) were seronegative to measles. In multivariate models, younger age or being vaccinated to measles, rather than previous measles disease, before transplantation were risk factors both for becoming seronegative and to have doubtfully protective immunity to measles. Acute GVHD grade II-IV was a risk factor for seronegativity and blood stem cells a risk factor for doubtfully protective immunity. Children and young adults previously immunized to measles have a high risk for becoming vulnerable to a measles infection. Since measles is again circulating in many countries and measles is a serious infection after SCT, vaccination should be considered.