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Title: Adjuvanted recombinant zoster vaccine in adult autologous stem cell transplant recipients: polyfunctional immune responses and lessons for clinical practice.
Austin Authors: Stadtmauer, Edward A;Sullivan, Keith M;El Idrissi, Mohamed;Salaun, Bruno;Alonso Alonso, Aránzazu;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;Polo Zarzuela, Marta;Schuind, Anne E;Shea, Thomas C;Sinisalo, Ulla Marjatta;Vural, Filiz;Yáñez San Segundo, Lucrecia;Zachée, Pierre;Bastidas, Adriana
Affiliation: Clinical Haematology
University of Pennsylvania, Philadelphia, PA, USA
Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
University of California Medical Center, San Francisco, CA, USA
GSK, Rockville, MD, USA
Halozyme Therapeutics, San Diego, CA, USA
Division of Hematology and Medical Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Hospital Quirón Madrid, Pozuelo de Alarcón, Spain
Hospital Universitario Central de Asturias, Oviedo, Spain
Hematology Department & CIBERONC, Instituto Carlos III, Hospital Universitario y Politécnico la fe, Valencia, Spain
Hospital Clínico San Carlos, Madrid, Spain
Hematology Department, Hospital Universitario Marqués De Valdecilla-IDIVAL, University of Cantabria, Santander, Spain
U.O. di Ematologia, Ospedale Santa Maria Delle Croci, Ravenna, Italy
Unità Operativa di Ematologia, Azienda Osp. Universitaria Arcispedale S. Anna, Cona, Italy
Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
GSK, Rue de l'Institut 89, Rixensart, Belgium
Inflammation Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Vancouver General Hospital, Vancouver, BC, Canada
GSK, Rue de l'Institut 89, Rixensart, Belgium
National Cancer Center, Goyang-si, Republic of Korea
Universitaetsklinikum Schleswig-Holstein, Kiel, Germany
Chonbuk National University Hospital, DukJin-Gu, Republic of Korea
CureVac AG, Tübingen, Germany
Hematology Unit, Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
Ege University Medical Faculty Hospital, Izmir, Turkey
Hematologie - Oncologie, Ziekenhuisnetwerk Antwerpen - ZNA Stuivenberg & ZNA Middelheim, Antwerpen, Belgium
GSK, Wavre, Belgium
Haematology and Transplant Unit, The Christie NHS Foundation Trust, Manchester, UK
Issue Date: 2-Nov-2021 2021-08-18
Publication information: Human Vaccines & Immunotherapeutics 2021; 17(11): 4144-4154
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.
DOI: 10.1080/21645515.2021.1953346
ORCID: 0000-0002-1379-9216
Journal: Human Vaccines & Immunotherapeutics
PubMed URL: 34406911
PubMed URL:
Type: Journal Article
Subjects: Autologous hematopoietic stem cell transplant
adjuvanted recombinant zoster vaccine
cell-mediated immunity
humoral immune response
vaccine efficacy
Appears in Collections:Journal articles

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