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Immunity to polioviruses and tetanus after bone marrow transplantation in children
C Pezzini1, M Limonta, A Rovelli
1Clinica Pediatrica dell'Università de Milano, Ospedale San Gerardo, Monza, Italy.
Insights
Children who received bone marrow transplants (BMT) often have weakened immunity to polioviruses, with many remaining seronegative years later. Tetanus toxoid immunity is generally preserved, suggesting tailored reimmunization strategies are needed post-BMT.
Area of Science:
- Immunology
- Transplantation immunology
- Vaccinology
Background:
- Bone marrow transplantation (BMT) is a critical procedure for various hematologic and oncologic conditions.
- Restoration of adaptive immunity following BMT is complex and can be incomplete.
- Assessing vaccine-induced immunity post-BMT is crucial for long-term patient health.
Purpose of the Study:
- To evaluate the long-term immunity to tetanus toxoid and polioviruses in pediatric BMT recipients.
- To determine the prevalence of seronegativity for specific vaccine-preventable diseases after BMT.
- To inform recommendations for post-transplant reimmunization protocols.
Main Methods:
- Study included 34 children (27 allografted, 7 autografted) who underwent BMT.
- Serologic testing for tetanus toxoid and poliovirus (types 1, 2, 3) antibody titers was performed.
- Immune status was assessed at a median of 3 years post-BMT.
Main Results:
- High seropositivity for tetanus toxoid was observed, with only one recipient seronegative.
- A significant proportion of children (73%) were seronegative for at least one poliovirus type.
- 30% of recipients were seronegative for all three poliovirus types, with higher rates against poliovirus type 3.
Conclusions:
- Immunity to tetanus toxoid is generally well-maintained after pediatric BMT.
- Humoral immunity to polioviruses is frequently impaired long-term post-BMT, particularly for type 3.
- Post-BMT reimmunization strategies should be guided by individual serologic antibody titers.
Abstract:
Immunity to tetanus toxoid and polioviruses was studied in 34 (27 allografted, 7 autografted) children who underwent bone marrow transplantation (BMT). At a median time of 3 years after BMT, only one recipient was seronegative for tetanus toxoid. On the contrary 73% of children were seronegative for at least one of the three poliovirus types and 30% for all virus types. Undetectable antibody titers were more frequently found against type 3 than the other two types. We recommend that reimmunizations of children after BMT be based on serologic tests for antibody titers.