[成年造血干细胞移植患者的免疫:当前的建议和临床应用]
1National Cancer Center Hospital East Division of Infectious Diseases.
[Rinsho ketsueki] The Japanese journal of clinical hematology
|October 1, 2025
概括
血造干细胞移植 (HSCT) 患者由于免疫力丧失,需要及时再接种疫苗. 本次审查涵盖了最佳的疫苗接种时间和新疫苗,以预防HSCT后的感染.
科学领域:
- 免疫学 免疫学 免疫学
- 移植医学 移植医学
- 预防传染病 预防传染病
背景情况:
- 造血干细胞移植 (HSCT) 显著损害免疫功能,导致失去先前存在的免疫力.
- 在HSCT后免疫复合是一个漫长的过程 (1-2年),受患者因素和移植特征的影响.
- 在HSCT后的时期,由于免疫抑制,感染的风险很高,尽管疫苗反应不足最佳.
研究的目的:
- 根据HSCT审查接种疫苗的基本原则.
- 在HSCT后的环境中讨论疫苗可预防疾病的具体考虑.
- 为了解决目前的证据和疫苗的可用性,包括在日本推出的新疫苗.
主要方法:
- 对HSCT后疫苗接种现有证据的文献综述.
- 对影响免疫复合和疫苗反应的因素的分析.
- 考虑新获得的疫苗 (复合杆菌,肺炎球菌合体,高剂量流感疫苗).
主要成果:
- 在HSCT后的免疫恢复是可变和长时间的,影响了疫苗的有效性.
- 由于免疫抑制,早期移植后接种疫苗是有争议的,但它解决了关键的脆弱性.
- 新的疫苗配方可能会为HSCT接受者提供更好的保护.
结论:
- 在HSCT后进行全面的再接种至关重要,以恢复保护性免疫力.
- 在HSCT后进行疫苗接种的最佳时机需要仔细考虑个体患者的因素和风险.
- 引入先进疫苗需要为HSCT接受者更新指南,以减轻疫苗可预防的疾病.
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