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Requiring Immunization After Rescue Autologous HSCT

  • Darko RichterEmail author
Chapter

Abstract

    • Patients with successful autologous or allogeneic hematopoietic stem-cell therapy should get booster courses of previous vaccinations

    • Additionally, the patient should get inactivated Inf, PCV and Men vaccine

    • Inactivated vaccines can generally be started at 6 months post HSCT, provided the child has no immunosuppression for the past 3 months, a lymphocyte count >1200/μL, and endogenous IgG > 500 mg/dL

    • Live vaccines are strictly contraindicated. Only MMR and Var can be considered in select well engrafted cases, no sooner than 24 months after HSCT. Requirement is CD4+ count >700/mL, endogenous IgG >500 mg/dL, and adequate serological response to inactivated vaccines, no immunosuppression and no GVHD

    • Passive immunoglobulin prophylaxis is established for measles by IVIG and for chickenpox by VZIG

    • Chemoprophylaxis with valacyclovir is available for chickenpox, in intramuscular and subcutaneous forms

    • The 16% HNIG concentrate can provide passive protection for measles, and to some extent hepatitis A and chickenpox

Keywords

Hematopoietic stem-cell therapy Booster immunization Inactivated vaccines Live attenuated vaccines 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Pediatric Allergy and Clinical ImmunologyUniversity Hospital Center ZagrebZagrebCroatia
  2. 2.Outpatient and Emergency Service, Department of PediatricsUniversity Hospital Center ZagrebZagrebCroatia

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