Cargando…
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...
Autores principales: | , , , , , , , , , , , , , , , , , |
---|---|
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 |
_version_ | 1785128429815857152 |
---|---|
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. |
format | Online Article Text |
id | pubmed-10611175 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT nikoloudisalexander successfulsarscov2mrnavaccinationprograminallogeneichematopoieticstemcelltransplantrecipientsaretrospectivesinglecenteranalysis AT neumanninesjulia successfulsarscov2mrnavaccinationprograminallogeneichematopoieticstemcelltransplantrecipientsaretrospectivesinglecenteranalysis AT buxhoferauschveronika successfulsarscov2mrnavaccinationprograminallogeneichematopoieticstemcelltransplantrecipientsaretrospectivesinglecenteranalysis AT machherndlspandlsigrid successfulsarscov2mrnavaccinationprograminallogeneichematopoieticstemcelltransplantrecipientsaretrospectivesinglecenteranalysis AT bindermichaela successfulsarscov2mrnavaccinationprograminallogeneichematopoieticstemcelltransplantrecipientsaretrospectivesinglecenteranalysis AT kaynakemine successfulsarscov2mrnavaccinationprograminallogeneichematopoieticstemcelltransplantrecipientsaretrospectivesinglecenteranalysis AT milanovrobert successfulsarscov2mrnavaccinationprograminallogeneichematopoieticstemcelltransplantrecipientsaretrospectivesinglecenteranalysis AT nockerstefanie successfulsarscov2mrnavaccinationprograminallogeneichematopoieticstemcelltransplantrecipientsaretrospectivesinglecenteranalysis AT stiefelolga successfulsarscov2mrnavaccinationprograminallogeneichematopoieticstemcelltransplantrecipientsaretrospectivesinglecenteranalysis AT strasslirene successfulsarscov2mrnavaccinationprograminallogeneichematopoieticstemcelltransplantrecipientsaretrospectivesinglecenteranalysis AT wipplingerdagmar successfulsarscov2mrnavaccinationprograminallogeneichematopoieticstemcelltransplantrecipientsaretrospectivesinglecenteranalysis AT moysesmargarete successfulsarscov2mrnavaccinationprograminallogeneichematopoieticstemcelltransplantrecipientsaretrospectivesinglecenteranalysis AT kerschnerheidrun successfulsarscov2mrnavaccinationprograminallogeneichematopoieticstemcelltransplantrecipientsaretrospectivesinglecenteranalysis AT apfalterpetra successfulsarscov2mrnavaccinationprograminallogeneichematopoieticstemcelltransplantrecipientsaretrospectivesinglecenteranalysis AT girschikofskymichael successfulsarscov2mrnavaccinationprograminallogeneichematopoieticstemcelltransplantrecipientsaretrospectivesinglecenteranalysis AT petzerandreas successfulsarscov2mrnavaccinationprograminallogeneichematopoieticstemcelltransplantrecipientsaretrospectivesinglecenteranalysis AT weltermannansgar successfulsarscov2mrnavaccinationprograminallogeneichematopoieticstemcelltransplantrecipientsaretrospectivesinglecenteranalysis AT clausenjohannes successfulsarscov2mrnavaccinationprograminallogeneichematopoieticstemcelltransplantrecipientsaretrospectivesinglecenteranalysis |