Changes in vaccination strategies contribute to the development of invasive pneumococcal disease in allogeneic hematopoietic stem cell transplantation recipients: a retrospective study for promoting vaccination

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients are at high risk of developing invasive pneumococcal disease (IPD) with substantial morbidity and mortality. Pneumococcal polysaccharide vaccine (PPSV23) and pneumococcal conjugate vaccine (PCV13) are the primary prevention st...

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Bibliographic Details
Published in:International journal of hematology 2021-08, Vol.114 (2), p.263-270
Main Authors: Konishi, Tatsuya, Sekiya, Noritaka, Otsuka, Yuki, Konuma, Ryosuke, Wada, Atsushi, Adachi, Hiroto, Kishida, Yuya, Nagata, Akihito, Yamada, Yuta, Noguchi, Yuma, Marumo, Atsushi, Mukae, Junichi, Inamoto, Kyoko, Toya, Takashi, Igarashi, Aiko, Najima, Yuho, Kobayashi, Takeshi, Sakamaki, Hisashi, Ohashi, Kazuteru, Doki, Noriko
Format: Article
Language:English
Subjects:
Guidelines
Hematology
Hematopoietic stem cells
Immunization
Medicine
Medicine & Public Health
Morbidity
Oncology
Original Article
Patients
Polysaccharides
Stem cell transplantation
Stem cells
Streptococcus infections
Transplantation
Vaccination
Vaccines
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Summary:Allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients are at high risk of developing invasive pneumococcal disease (IPD) with substantial morbidity and mortality. Pneumococcal polysaccharide vaccine (PPSV23) and pneumococcal conjugate vaccine (PCV13) are the primary prevention strategy. The difference between the Japanese and international guidelines is limited except when to start PCV13. However, Japanese data regarding the incidence of IPD after allo-HSCT that include vaccination status are limited. Therefore, we aimed to study the clinical characteristics of patients with IPD following allo-HSCT, focusing on unvaccinated patients. We retrospectively reviewed allo-HSCT recipients between April 2005 and December 2018 at Komagome Hospital. Among 1,091 recipients, 11 (1008/100,000 recipients) developed 13 episodes of IPD. The median period from the first allo-HSCT to the first IPD episode was 686 days (10–3040 days). Ten patients developed IPD before vaccination, and seven of these unvaccinated patients with late-onset IPD were ineligible for vaccination based on domestic guidelines. Although appropriate treatments resulted in a good short-term prognosis, most episodes of IPD developed in unvaccinated allo-HSCT recipients. Our data support the promotion of better adherence to the current guidelines and the importance of pneumococcal vaccination even years after allo-HSCT to protect against late-onset IPD.
ISSN:0925-5710
1865-3774
DOI:10.1007/s12185-021-03146-2