Association of Host Factors With Antibody Response to Seasonal Influenza Vaccination in Allogeneic Hematopoietic Stem Cell Transplant Patients. (20th August 2021)

• Record Type: Journal Article
• Authors: Linnik, Janina; Syedbasha, Mohammedyaseen; Kaltenbach, Hans-Michael; Vogt, Dominik; Hollenstein, Yvonne; Kaufmann, Lukas; Cantoni, Nathan; Ruosch-Girsberger, Sabine; Müller, Antonia M S; Schanz, Urs; Pabst, Thomas; Stüssi, Georg; Weisser, Maja; Halter, Jörg; Stelling, Jörg; Egli, Adrian
• Is Part Of: Journal of infectious diseases. Volume 225:Number 8(2022)
• Page Start: 1482
• Page End: 1493
• Publication Date: 2021-08-20
• Subjects: influenza -- vaccination -- hematopoietic stem cell transplantation -- immunosuppression -- graft-versus-host disease -- hemagglutination inhibition titer -- seroconversion -- categorical regression -- sequential model; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiab391
• Languages: English
• ISSNs: 0022-1899

Abstract

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. Abstract : Patients after hematopoietic stem cell transplantation show a highly heterogeneous antibody response to seasonal influenza vaccination that can be partially explained by easily accessible clinical data such as the type of immunosuppressive treatment, absolute lymphocyte count, and donor relationship.