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Safety of vaccinating sibling donors with live-attenuated varicella zoster vaccine before hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 39, pages 661–665 (2007)Cite this article

Abstract

Reactivation of varicella zoster virus (VZV), clinically manifested as herpes zoster (HZ) is a common complication after hematopoietic stem cell transplantation (HSCT). The optimum prophylaxis for this disease has not been defined. In this study, we examined the effects of vaccinating donors with a live-attenuated vaccine with particular reference to their immune responses and the outcome of HSCT patients. Forty prospective HLA-matched sibling donors were vaccinated before HSCT. There were humoral immune responses in both sero-positive (P<0.01) and sero-negative (P=0.058) donors. Cellular immune response was assayed in 26 donors. Significant correlation was observed between cellular immune responses as enumerated by thymidine incorporation and interferon γ secretion (P<0.001) and the latter was used in subsequent analyses. Significant response was observed in sero-negative (6/26) and a group of sero-positive (13/26) donors while 7/26 sero-positive donors showed no response. Thirty-four HSCT were performed. These patients have a lower, albeit insignificant, risk of HZ compared with historical controls and only 3/34 patients developed single dermatomal HZ at 6, 9 and 28 months after HSCT. No patients developed VZV-related mortality. Vaccinating donors with live-attenuated VZV vaccine was safe, but whether it confers a significant protection to the patients would require further study.

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Acknowledgements

This project was supported by CERG (HKU7443/03M) to RL, a small project funding from HKU to AYHL and a departmental research grant to AKWL.

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Authors and Affiliations

  1. Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China

    A Y H Leung, H C H Chow, C K H Lui, A K W Lie & R Liang

  2. Department of Pathology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China

    J S Y Kwok

  3. Department of Microbiology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China

    V C C Cheng & K-Y Yuen

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  1. A Y H Leung
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  2. H C H Chow
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  7. A K W Lie
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Correspondence to A Y H Leung.

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Leung, A., Chow, H., Kwok, J. et al. Safety of vaccinating sibling donors with live-attenuated varicella zoster vaccine before hematopoietic stem cell transplantation. Bone Marrow Transplant 39, 661–665 (2007). https://doi.org/10.1038/sj.bmt.1705673

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