학술논문
Adjuvanted recombinant zoster vaccine in adult autologous stem cell transplant recipients: polyfunctional immune responses and lessons for clinical practice
Document Type
article
Author
Stadtmauer, Edward A; Sullivan, Keith M; Idrissi, Mohamed El; Salaun, Bruno; Alonso, Aránzazu Alonso; Andreadis, Charalambos; Anttila, Veli-Jukka; Bloor, Adrian JC; Broady, Raewyn; Cellini, Claudia; Cuneo, Antonio; Dagnew, Alemnew F; Di Paolo, Emmanuel; Eom, HyeonSeok; González-Rodríguez, Ana Pilar; Grigg, Andrew; Guenther, Andreas; Heineman, Thomas C; Jarque, Isidro; Kwak, Jae-Yong; Lucchesi, Alessandro; Oostvogels, Lidia; Zarzuela, Marta Polo; Schuind, Anne E; Shea, Thomas C; Sinisalo, Ulla Marjatta; Vural, Filiz; San Segundo, Lucrecia Yáñez; Zachée, Pierre; Bastidas, Adriana
Source
Human Vaccines & Immunotherapeutics. 17(11)
Subject
Language
Abstract
Immunocompromised individuals, particularly autologous hematopoietic stem cell transplant (auHSCT) recipients, are at high risk for herpes zoster (HZ). We provide an in-depth description of humoral and cell-mediated immune (CMI) responses by age (protocol-defined) or underlying disease (post-hoc) as well as efficacy by underlying disease (post-hoc) of the adjuvanted recombinant zoster vaccine (RZV) in a randomized observer-blind phase III trial (ZOE-HSCT, NCT01610414). 1846 adult auHSCT recipients were randomized to receive a first dose of either RZV or placebo 50-70 days post-auHSCT, followed by the second dose at 1-2 months (M) later. In cohorts of 114-1721 participants, at 1 M post-second vaccine dose: Anti-gE antibody geometric mean concentrations (GMCs) and median gE-specific CD4[2+] T-cell frequencies (CD4 T cells expressing ≥2 of four assessed activation markers) were similar between 18-49 and ≥50-year-olds. Despite lower anti-gE antibody GMCs in non-Hodgkin B-cell lymphoma (NHBCL) patients, CD4[2+] T-cell frequencies were similar between NHBCL and other underlying diseases. The proportion of polyfunctional CD4 T cells increased over time, accounting for 79.6% of gE-specific CD4 T cells at 24 M post-dose two. Vaccine efficacy against HZ ranged between 42.5% and 82.5% across underlying diseases and was statistically significant in NHBCL and multiple myeloma patients. In conclusion, two RZV doses administered early post-auHSCT induced robust, persistent, and polyfunctional gE-specific immune responses. Efficacy against HZ was also high in NHBCL patients despite the lower humoral response.