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Post-Transplant Events

Early measles vaccination in bone marrow transplant recipients

Bone Marrow Transplantation volume 35, pages 787–791 (2005)Cite this article

Summary:

Measles vaccination has been recommended after the second year following bone marrow transplant (BMT) in patients not receiving immunosuppressive drugs. During a measles outbreak, we vaccinated all patients after the first year of transplant, and conducted a prospective trial to evaluate safety, effectiveness and sustained immunity after early vaccination. Patients received attenuated virus vaccine between 9 and 18 months after BMT. A total of 51 patients were evaluated and 27 of them (52.9%) were receiving immunosuppressive drugs. Only mild adverse reactions were noted. Nine patients (17.6%) were susceptible (IgG⩽100 mIU/ml) at vaccination, and all seroconverted. In those immune at vaccination, a four-fold increase in measles IgG titers was found in one of 34 patients (2.9%) with specific IgG⩾200 mIU/ml compared to 14 of 17 (82.3%) with IgG<200 mIU/ml (P< 0.0001). Sustained immunity after 24 months was more likely to occur in patients with specific IgG levels⩽200 or ⩾500 mIU/mL (83.4 and 100%, respectively) in comparison to patients with 200<499 mIU/ml at vaccination (50% P=0.017). We conclude that even though early measles vaccination is safe, few patients are susceptible on day +365 and this strategy should be reserved for epidemic situations posing significant threat for the patients.

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Acknowledgements

We thank the doctors assisting the BMT Program, Ana Verena A Mendes, MD, Maria Cristina A Macedo, MD, Roberto L Silva, MD; Rosaura Saboya, MD for excellent patient care and Marta H Lopes, MD, from the Centro de Referência para Imunobiológicos Especiais (CRIE), Hospital das Clínicas, University of São Paulo Medical School.

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Authors and Affiliations

  1. Virology Laboratory (LIM 52-HCFMUSP) – Institute of Tropical Medicine, University of São Paulo Medical School, São Paulo, Brazil

    C M Machado, VAUF de Souza, L M Sumita & C S Pannuti

  2. BMT Program, Discipline of Hematology, University of São Paulo Medical School, São Paulo, Brazil

    C M Machado, IF da Rocha & F L Dulley

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  1. C M Machado
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  2. VAUF de Souza
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  3. L M Sumita
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  6. C S Pannuti
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Correspondence to C M Machado.

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Machado, C., de Souza, V., Sumita, L. et al. Early measles vaccination in bone marrow transplant recipients. Bone Marrow Transplant 35, 787–791 (2005). https://doi.org/10.1038/sj.bmt.1704878

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