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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| Format: | Article |
| Language: | English |
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MDPI AG
2023-09-01
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| Series: | Vaccines |
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| Online Access: | https://www.mdpi.com/2076-393X/11/10/1534 |
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| author | Alexander Nikoloudis Ines Julia Neumann Veronika Buxhofer-Ausch Sigrid Machherndl-Spandl Michaela Binder Emine Kaynak Robert Milanov Stefanie Nocker Olga Stiefel Irene Strassl Dagmar Wipplinger Margarete Moyses Heidrun Kerschner Petra Apfalter Michael Girschikofsky Andreas Petzer Ansgar Weltermann Johannes Clausen |
| author_facet | Alexander Nikoloudis Ines Julia Neumann Veronika Buxhofer-Ausch Sigrid Machherndl-Spandl Michaela Binder Emine Kaynak Robert Milanov Stefanie Nocker Olga Stiefel Irene Strassl Dagmar Wipplinger Margarete Moyses Heidrun Kerschner Petra Apfalter Michael Girschikofsky Andreas Petzer Ansgar Weltermann Johannes Clausen |
| author_sort | Alexander Nikoloudis |
| collection | DOAJ |
| 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 (<i>p</i> < 0.001). Higher CD19 (B cell) counts favored vaccination response (adjusted odds ratio (aOR) 3.3 per 100 B-cells/microliters, <i>p</i> < 0.001), while ongoing mycophenolate mofetil (MMF) immunosuppression hindered it (aOR 0.04, <i>p</i> < 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. |
| first_indexed | 2024-03-10T20:50:02Z |
| format | Article |
| id | doaj.art-8fe579c44ccc4d78963dac1562610171 |
| institution | Directory Open Access Journal |
| issn | 2076-393X |
| language | English |
| last_indexed | 2024-03-10T20:50:02Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vaccines |
| spelling | doaj.art-8fe579c44ccc4d78963dac15626101712023-11-19T18:24:07ZengMDPI AGVaccines2076-393X2023-09-011110153410.3390/vaccines11101534Successful SARS-CoV-2 mRNA Vaccination Program in Allogeneic Hematopoietic Stem Cell Transplant Recipients—A Retrospective Single-Center AnalysisAlexander Nikoloudis0Ines Julia Neumann1Veronika Buxhofer-Ausch2Sigrid Machherndl-Spandl3Michaela Binder4Emine Kaynak5Robert Milanov6Stefanie Nocker7Olga Stiefel8Irene Strassl9Dagmar Wipplinger10Margarete Moyses11Heidrun Kerschner12Petra Apfalter13Michael Girschikofsky14Andreas Petzer15Ansgar Weltermann16Johannes Clausen17Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz—Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, AustriaMedical Faculty, Johannes Kepler University, 4020 Linz, AustriaDepartment of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz—Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, AustriaDepartment of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz—Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, AustriaDepartment of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz—Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, AustriaDepartment of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz—Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, AustriaDepartment of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz—Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, AustriaDepartment of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz—Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, AustriaDepartment of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz—Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, AustriaDepartment of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz—Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, AustriaDepartment of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz—Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, AustriaDepartment of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz—Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, AustriaInterdisciplinary Center for Infectious Medicine and Microbiology, Linz, AustriaInterdisciplinary Center for Infectious Medicine and Microbiology, Linz, AustriaDepartment of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz—Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, AustriaDepartment of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz—Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, AustriaDepartment of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz—Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, AustriaDepartment of Internal Medicine I: Hematology with Stem Cell Transplantation, Ordensklinikum Linz—Elisabethinen, Hemostaseology and Medical Oncology, 4020 Linz, Austria(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 (<i>p</i> < 0.001). Higher CD19 (B cell) counts favored vaccination response (adjusted odds ratio (aOR) 3.3 per 100 B-cells/microliters, <i>p</i> < 0.001), while ongoing mycophenolate mofetil (MMF) immunosuppression hindered it (aOR 0.04, <i>p</i> < 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.https://www.mdpi.com/2076-393X/11/10/1534COVID-19HSCTvaccinationtransplantation |
| spellingShingle | Alexander Nikoloudis Ines Julia Neumann Veronika Buxhofer-Ausch Sigrid Machherndl-Spandl Michaela Binder Emine Kaynak Robert Milanov Stefanie Nocker Olga Stiefel Irene Strassl Dagmar Wipplinger Margarete Moyses Heidrun Kerschner Petra Apfalter Michael Girschikofsky Andreas Petzer Ansgar Weltermann Johannes Clausen Successful SARS-CoV-2 mRNA Vaccination Program in Allogeneic Hematopoietic Stem Cell Transplant Recipients—A Retrospective Single-Center Analysis Vaccines COVID-19 HSCT vaccination transplantation |
| 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 | COVID-19 HSCT vaccination transplantation |
| url | https://www.mdpi.com/2076-393X/11/10/1534 |
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