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Successful SARS-CoV-2 mRNA Vaccination Program in Allogeneic Hematopoietic Stem Cell Transplant Recipients—A Retrospective Single-Center Analysis

(1) Background: mRNA COVID-19 vaccines are effective but show varied efficacy in immunocompromised patients, including allogeneic hematopoietic stem cell transplant (HSCT) recipients. (2) Methods: A retrospective study on 167 HSCT recipients assessed humoral response to two mRNA vaccine doses, using...

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Autores principales: Nikoloudis, Alexander, Neumann, Ines Julia, Buxhofer-Ausch, Veronika, Machherndl-Spandl, Sigrid, Binder, Michaela, Kaynak, Emine, Milanov, Robert, Nocker, Stefanie, Stiefel, Olga, Strassl, Irene, Wipplinger, Dagmar, Moyses, Margarete, Kerschner, Heidrun, Apfalter, Petra, Girschikofsky, Michael, Petzer, Andreas, Weltermann, Ansgar, Clausen, Johannes
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10611175/
https://www.ncbi.nlm.nih.gov/pubmed/37896938
http://dx.doi.org/10.3390/vaccines11101534
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author Nikoloudis, Alexander
Neumann, Ines Julia
Buxhofer-Ausch, Veronika
Machherndl-Spandl, Sigrid
Binder, Michaela
Kaynak, Emine
Milanov, Robert
Nocker, Stefanie
Stiefel, Olga
Strassl, Irene
Wipplinger, Dagmar
Moyses, Margarete
Kerschner, Heidrun
Apfalter, Petra
Girschikofsky, Michael
Petzer, Andreas
Weltermann, Ansgar
Clausen, Johannes
author_facet Nikoloudis, Alexander
Neumann, Ines Julia
Buxhofer-Ausch, Veronika
Machherndl-Spandl, Sigrid
Binder, Michaela
Kaynak, Emine
Milanov, Robert
Nocker, Stefanie
Stiefel, Olga
Strassl, Irene
Wipplinger, Dagmar
Moyses, Margarete
Kerschner, Heidrun
Apfalter, Petra
Girschikofsky, Michael
Petzer, Andreas
Weltermann, Ansgar
Clausen, Johannes
author_sort Nikoloudis, Alexander
collection PubMed
description (1) Background: mRNA COVID-19 vaccines are effective but show varied efficacy in immunocompromised patients, including allogeneic hematopoietic stem cell transplant (HSCT) recipients. (2) Methods: A retrospective study on 167 HSCT recipients assessed humoral response to two mRNA vaccine doses, using the manufacturer cut-off of ≥7.1 BAU/mL, and examined factors affecting non-response. (3) Results: Twenty-two percent of HSCT recipients failed humoral response. Non-responders received the first vaccine a median of 10.2 (2.5–88.9) months post-HSCT versus 35.3 (3.0–215.0) months for responders (p < 0.001). Higher CD19 (B cell) counts favored vaccination response (adjusted odds ratio (aOR) 3.3 per 100 B-cells/microliters, p < 0.001), while ongoing mycophenolate mofetil (MMF) immunosuppression hindered it (aOR 0.04, p < 0.001). By multivariable analysis, the time from transplant to first vaccine did not remain a significant risk factor. A total of 92% of non-responders received a third mRNA dose, achieving additional 77% seroconversion. Non-converters mostly received a fourth dose, with an additional 50% success. Overall, a cumulative seroconversion rate of 93% was achieved after up to four doses. (4) Conclusion: mRNA vaccines are promising for HSCT recipients as early as 3 months post-HSCT. A majority seroconverted after four doses. MMF usage and low B cell counts are risk factors for non-response.
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spelling pubmed-106111752023-10-28 Successful SARS-CoV-2 mRNA Vaccination Program in Allogeneic Hematopoietic Stem Cell Transplant Recipients—A Retrospective Single-Center Analysis Nikoloudis, Alexander Neumann, Ines Julia Buxhofer-Ausch, Veronika Machherndl-Spandl, Sigrid Binder, Michaela Kaynak, Emine Milanov, Robert Nocker, Stefanie Stiefel, Olga Strassl, Irene Wipplinger, Dagmar Moyses, Margarete Kerschner, Heidrun Apfalter, Petra Girschikofsky, Michael Petzer, Andreas Weltermann, Ansgar Clausen, Johannes Vaccines (Basel) Article (1) Background: mRNA COVID-19 vaccines are effective but show varied efficacy in immunocompromised patients, including allogeneic hematopoietic stem cell transplant (HSCT) recipients. (2) Methods: A retrospective study on 167 HSCT recipients assessed humoral response to two mRNA vaccine doses, using the manufacturer cut-off of ≥7.1 BAU/mL, and examined factors affecting non-response. (3) Results: Twenty-two percent of HSCT recipients failed humoral response. Non-responders received the first vaccine a median of 10.2 (2.5–88.9) months post-HSCT versus 35.3 (3.0–215.0) months for responders (p < 0.001). Higher CD19 (B cell) counts favored vaccination response (adjusted odds ratio (aOR) 3.3 per 100 B-cells/microliters, p < 0.001), while ongoing mycophenolate mofetil (MMF) immunosuppression hindered it (aOR 0.04, p < 0.001). By multivariable analysis, the time from transplant to first vaccine did not remain a significant risk factor. A total of 92% of non-responders received a third mRNA dose, achieving additional 77% seroconversion. Non-converters mostly received a fourth dose, with an additional 50% success. Overall, a cumulative seroconversion rate of 93% was achieved after up to four doses. (4) Conclusion: mRNA vaccines are promising for HSCT recipients as early as 3 months post-HSCT. A majority seroconverted after four doses. MMF usage and low B cell counts are risk factors for non-response. MDPI 2023-09-28 /pmc/articles/PMC10611175/ /pubmed/37896938 http://dx.doi.org/10.3390/vaccines11101534 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Nikoloudis, Alexander
Neumann, Ines Julia
Buxhofer-Ausch, Veronika
Machherndl-Spandl, Sigrid
Binder, Michaela
Kaynak, Emine
Milanov, Robert
Nocker, Stefanie
Stiefel, Olga
Strassl, Irene
Wipplinger, Dagmar
Moyses, Margarete
Kerschner, Heidrun
Apfalter, Petra
Girschikofsky, Michael
Petzer, Andreas
Weltermann, Ansgar
Clausen, Johannes
Successful SARS-CoV-2 mRNA Vaccination Program in Allogeneic Hematopoietic Stem Cell Transplant Recipients—A Retrospective Single-Center Analysis
title Successful SARS-CoV-2 mRNA Vaccination Program in Allogeneic Hematopoietic Stem Cell Transplant Recipients—A Retrospective Single-Center Analysis
title_full Successful SARS-CoV-2 mRNA Vaccination Program in Allogeneic Hematopoietic Stem Cell Transplant Recipients—A Retrospective Single-Center Analysis
title_fullStr Successful SARS-CoV-2 mRNA Vaccination Program in Allogeneic Hematopoietic Stem Cell Transplant Recipients—A Retrospective Single-Center Analysis
title_full_unstemmed Successful SARS-CoV-2 mRNA Vaccination Program in Allogeneic Hematopoietic Stem Cell Transplant Recipients—A Retrospective Single-Center Analysis
title_short Successful SARS-CoV-2 mRNA Vaccination Program in Allogeneic Hematopoietic Stem Cell Transplant Recipients—A Retrospective Single-Center Analysis
title_sort successful sars-cov-2 mrna vaccination program in allogeneic hematopoietic stem cell transplant recipients—a retrospective single-center analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10611175/
https://www.ncbi.nlm.nih.gov/pubmed/37896938
http://dx.doi.org/10.3390/vaccines11101534
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