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Measles immunity after allogeneic stem cell transplantation; influence of donor type, graft type, intensity of conditioning, and graft-versus host disease.
Ljungman, P; Aschan, J; Barkholt, L; Broliden, P-A; Gustafsson, B; Lewensohn-Fuchs, I; Löfgren, C; Winiarski, J; Ringdén, O.
Affiliation
  • Ljungman P; Department of Hematology, Karolinska University Hospital/Huddinge, Stockholm, Sweden. per.Ljungman@medhs.ki.se
Bone Marrow Transplant ; 34(7): 589-93, 2004 Oct.
Article in En | MEDLINE | ID: mdl-15300234
ABSTRACT
During follow-up after allogeneic stem cell transplantation (SCT), patients frequently lose their immunity to infectious agents such as measles. The aim of this study was to analyze the influence of different factors on measles immunity. In total, 395 patients with a disease-free survival of at least 1 year were included. Measles vaccination was given at 2 years after SCT to children and young adults without chronic GVHD or ongoing immunosuppression. In all, 264 patients had matched sibling donors and 131 either mismatched family or unrelated donors. Totally, 318 patients received bone marrow and 77 peripheral blood stem cells. Overall, 375 patients had undergone myeloablative and 20 nonmyeloablative conditioning. Out of 395 patients, 133 (34%) were seronegative to measles. In multivariate models, younger age or being vaccinated to measles, rather than previous measles disease, before transplantation were risk factors both for becoming seronegative and to have doubtfully protective immunity to measles. Acute GVHD grade II-IV was a risk factor for seronegativity and blood stem cells a risk factor for doubtfully protective immunity. Children and young adults previously immunized to measles have a high risk for becoming vulnerable to a measles infection. Since measles is again circulating in many countries and measles is a serious infection after SCT, vaccination should be considered.
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Collection: 01-internacional Database: MEDLINE Main subject: Measles Vaccine / Hematopoietic Stem Cell Transplantation / Transplantation Conditioning / Graft vs Host Disease / Measles Type of study: Etiology_studies / Prognostic_studies / Risk_factors_studies Limits: Adolescent / Adult / Child / Child, preschool / Humans / Infant / Middle aged Language: En Journal: Bone Marrow Transplant Journal subject: TRANSPLANTE Year: 2004 Document type: Article Affiliation country: Suecia
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Collection: 01-internacional Database: MEDLINE Main subject: Measles Vaccine / Hematopoietic Stem Cell Transplantation / Transplantation Conditioning / Graft vs Host Disease / Measles Type of study: Etiology_studies / Prognostic_studies / Risk_factors_studies Limits: Adolescent / Adult / Child / Child, preschool / Humans / Infant / Middle aged Language: En Journal: Bone Marrow Transplant Journal subject: TRANSPLANTE Year: 2004 Document type: Article Affiliation country: Suecia