RESUMO
The guidelines for immunization of hematopoietic SCT (HSCT) recipients recommend three doses of antipneumococcal conjugate vaccine (PCV) from 3 to 6 months after transplant, followed by a dose of polysaccharide 23-valent (PPV23) vaccine at 12 months in the case of no GVHD or an additional PCV dose in the case of GVHD. Due to the lack of long-term data in the literature, there is no recommendation for boosts after 12 months. Our goal was to assess the maintenance of the immune response to pneumococcal vaccines in patients vaccinated 10 years ago according to current guidelines. Thirty surviving patients of the IDWP01 (Infectious Diseases Working Party 1) trial were assessed for antibody levels against the seven antigens of the PCV7 and against two of the PPV23-specific antigens. When compared with 24 months after transplant, the immune response did not significantly decrease but with important serotype-specific variability. There was no evidence that an additional dose of PPV23 given to 11/30 patients 2-11 years after transplant was beneficial. In long-term HSCT survivors with no or few GVHD vaccinated against Streptococcus pneumoniae according to the current guidelines, the specific immunity is not fully maintained a decade later. The optimal schedule of antipneumococcal vaccination in HSCT recipients after 12 months remains to be established.
Assuntos
Transplante de Células-Tronco Hematopoéticas/métodos , Vacina Pneumocócica Conjugada Heptavalente/imunologia , Condicionamento Pré-Transplante/métodos , Transplante Homólogo/métodos , Adolescente , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemAssuntos
Genes Transgênicos Suicidas , Terapia Genética , Imunoterapia Adotiva , Linfócitos/metabolismo , Neoplasias/genética , Neoplasias/terapia , Doença Enxerto-Hospedeiro/etiologia , Humanos , Imunoterapia Adotiva/efeitos adversos , Depleção Linfocítica , Linfócitos/imunologia , Neoplasias/complicações , Neoplasias/imunologia , Doadores de Tecidos , Transdução Genética , Resultado do TratamentoAssuntos
Carbapenêmicos/metabolismo , Escherichia coli/enzimologia , Klebsiella pneumoniae/enzimologia , Resistência beta-Lactâmica/fisiologia , beta-Lactamases/metabolismo , Animais , Austrália , Escherichia coli/efeitos dos fármacos , Escherichia coli/genética , Humanos , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/genética , Reação em Cadeia da Polimerase , beta-Lactamases/genéticaRESUMO
Association study is the method of choice to identify genes involved in complex processes that result from the interaction of environmental and genetic factors. However, because of biases that increase the risk of false positive reports, preliminary positive conclusions have to be reproduced on other populations to be validated as firm conclusions. In 1994, certain alleles of two genes, APOE (Apolipoprotein E) and ACE (angiotensin converting enzyme), were reported to be more frequent in French centenarians, suggesting an association with such a complex polyfactorial process as longevity. Enlargement of the French centenarian cohort allows a new assessment of this hypothesis on 563 centenarians. In contrast to APOE, the ACE association was not confirmed. Retrospective analysis of the initial study revealed discrepancies that may in part explain this observation. Risk of reporting false positive associations is discussed and recommendations to set up a rigorous experimental design are proposed.
