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Changes in vaccination strategies contribute to the development of invasive pneumococcal disease in allogeneic hematopoietic stem cell transplantation recipients: a retrospective study for promoting vaccination

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Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients are at high risk of developing invasive pneumococcal disease (IPD) with substantial morbidity and mortality. Pneumococcal polysaccharide vaccine (PPSV23) and pneumococcal conjugate vaccine (PCV13) are the primary prevention strategy. The difference between the Japanese and international guidelines is limited except when to start PCV13. However, Japanese data regarding the incidence of IPD after allo-HSCT that include vaccination status are limited. Therefore, we aimed to study the clinical characteristics of patients with IPD following allo-HSCT, focusing on unvaccinated patients. We retrospectively reviewed allo-HSCT recipients between April 2005 and December 2018 at Komagome Hospital. Among 1,091 recipients, 11 (1008/100,000 recipients) developed 13 episodes of IPD. The median period from the first allo-HSCT to the first IPD episode was 686 days (10–3040 days). Ten patients developed IPD before vaccination, and seven of these unvaccinated patients with late-onset IPD were ineligible for vaccination based on domestic guidelines. Although appropriate treatments resulted in a good short-term prognosis, most episodes of IPD developed in unvaccinated allo-HSCT recipients. Our data support the promotion of better adherence to the current guidelines and the importance of pneumococcal vaccination even years after allo-HSCT to protect against late-onset IPD.

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Acknowledgements

The authors would like to thank the nursing staff at Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, for their excellent patient care.

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Authors and Affiliations

  1. Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan

    Tatsuya Konishi, Yuki Otsuka, Ryosuke Konuma, Atsushi Wada, Hiroto Adachi, Yuya Kishida, Akihito Nagata, Yuta Yamada, Yuma Noguchi, Atsushi Marumo, Junichi Mukae, Kyoko Inamoto, Takashi Toya, Aiko Igarashi, Yuho Najima, Takeshi Kobayashi, Hisashi Sakamaki, Kazuteru Ohashi & Noriko Doki

  2. Department of Infection Prevention and Control, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Hon-komagome, Bunkyo-ku, Tokyo, 1138677, Japan

    Tatsuya Konishi & Noritaka Sekiya

  3. Department of Clinical Laboratory, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan

    Noritaka Sekiya

Authors
  1. Tatsuya Konishi
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  2. Noritaka Sekiya
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  3. Yuki Otsuka
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  4. Ryosuke Konuma
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  18. Hisashi Sakamaki
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  19. Kazuteru Ohashi
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  20. Noriko Doki
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Contributions

TK, NS, and ND contributed to data collection and wrote the manuscript. All authors contributed to the clinical care of the patient and approved the final version of the manuscript.

Corresponding author

Correspondence to Noritaka Sekiya.

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The authors declare no conflicts of interest associated with this article. No external funding was received for this study.

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Konishi, T., Sekiya, N., Otsuka, Y. et al. Changes in vaccination strategies contribute to the development of invasive pneumococcal disease in allogeneic hematopoietic stem cell transplantation recipients: a retrospective study for promoting vaccination. Int J Hematol 114, 263–270 (2021). https://doi.org/10.1007/s12185-021-03146-2

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  • DOI: https://doi.org/10.1007/s12185-021-03146-2

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