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Serum IgM levels independently predict immune response to influenza vaccine in long-term survivors vaccinated at >1 year after undergoing allogeneic hematopoietic stem cell transplantation

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Abstract

Influenza virus infection can cause fatal complications (e.g., pneumonia) in immunodeficient long-term survivors of allogeneic hematopoietic stem cell transplantation (allo-HSCT). The immune response to the vaccine improves if it is administered at >1 year after allo-HSCT, although the response may vary according to the patient’s immune status. We sought to identify predictors of immune response to trivalent inactivated influenza vaccine (TIV) among patients vaccinated at >1 year after allo-HSCT. We included 27 allo-HSCT recipients, with a median interval of 4.3 years (range 1.0–10.1 years) from transplantation to vaccination. Nineteen patients achieved a response to TIV, although a low immune response to TIV was significantly associated with calcineurin inhibitor treatment, and moderate chronic graft-versus-host disease and IgM levels of <0.5 g/L at the time of vaccination. Multivariate analysis revealed that IgM levels of <0.5 g/L at the vaccination were an independent predictor of a low immune response to TIV. These results indicate that a more effective approach is needed to induce a vaccine-specific immune response among long-term survivors of allo-HSCT who have low serum IgM levels.

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Acknowledgements

We thank the patients for participating in this study, and Dr. Kazunori Ohnishi for reviewing the manuscript. Y.F. is a PhD candidate at the Hamamatsu University School of Medicine and this work is being submitted as a part of the PhD program.

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Authors and Affiliations

  1. Division of Hematology, Internal Medicine 3, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan

    Yusuke Fukatsu, Yasuyuki Nagata, Miwa Adachi, Tomohiro Yagyu & Takaaki Ono

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  1. Yusuke Fukatsu
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  2. Yasuyuki Nagata
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  3. Miwa Adachi
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  4. Tomohiro Yagyu
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  5. Takaaki Ono
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Correspondence to Takaaki Ono.

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Fukatsu, Y., Nagata, Y., Adachi, M. et al. Serum IgM levels independently predict immune response to influenza vaccine in long-term survivors vaccinated at >1 year after undergoing allogeneic hematopoietic stem cell transplantation. Int J Hematol 105, 638–645 (2017). https://doi.org/10.1007/s12185-016-2163-3

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  • DOI: https://doi.org/10.1007/s12185-016-2163-3

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