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    Adjuvanted recombinant zoster vaccine in adult autologous stem cell transplant recipients: polyfunctional immune responses and lessons for clinical practice

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    Authors
    Stadtmauer, E. A.
    Sullivan, K. M.
    El Idrissi, M.
    Salaun, B.
    Alonso Alonso, A.
    Andreadis, C.
    Anttila, V. J.
    Bloor, Adrian
    Broady, R.
    Cellini, C.
    Cuneo, A.
    Dagnew, A. F.
    Di Paolo, E.
    Eom, H.
    González-Rodríguez, A. P.
    Grigg, A.
    Gunther, A.
    Heineman, T. C.
    Jarque, I.
    Kwak, J. Y.
    Lucchesi, A.
    Oostvogels, L.
    Polo Zarzuela, M.
    Schuind, A. E.
    Shea, T. C.
    Sinisalo, U. M.
    Vural, F.
    Yáñez San Segundo, L.
    Zachée, P
    Bastidas, A.
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    Affiliation
    University of Pennsylvania, Philadelphia, PA, USA
    Issue Date
    2021
    
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    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.
    Citation
    Stadtmauer EA, Sullivan KM, El Idrissi M, Salaun B, Alonso Alonso A, Andreadis C, et al. Adjuvanted recombinant zoster vaccine in adult autologous stem cell transplant recipients: polyfunctional immune responses and lessons for clinical practice. Human Vaccines & Immunotherapeutics. 2021 Aug 18;1–11.
    Journal
    Human Vaccines and Immunotherapeutics
    URI
    http://hdl.handle.net/10541/624527
    DOI
    10.1080/21645515.2021.1953346
    PubMed ID
    34406911
    Additional Links
    https://dx.doi.org/10.1080/21645515.2021.1953346
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1080/21645515.2021.1953346
    Scopus Count
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