Transfer of influenza vaccine-primed costimulated autologous T cells after stem cell transplantation for multiple myeloma leads to reconstitution of influenza immunity: results of a randomized clinical trial
Edward A Stadtmauer, Dan T Vogl, Eline Luning Prak, Jean Boyer, Nicole A Aqui, Aaron P Rapoport, Kenyetta R McDonald, Xiaoling Hou, Heather Murphy, Rita Bhagat, Patricia A Mangan, Anne Chew, Elizabeth A Veloso, Bruce L Levine, Robert H Vonderheide, Abbas F Jawad, Carl H June, Kathleen E Sullivan, Edward A Stadtmauer, Dan T Vogl, Eline Luning Prak, Jean Boyer, Nicole A Aqui, Aaron P Rapoport, Kenyetta R McDonald, Xiaoling Hou, Heather Murphy, Rita Bhagat, Patricia A Mangan, Anne Chew, Elizabeth A Veloso, Bruce L Levine, Robert H Vonderheide, Abbas F Jawad, Carl H June, Kathleen E Sullivan
Abstract
Severe immune deficiency follows autologous stem cell transplantation for multiple myeloma and is associated with significant infectious morbidity. This study was designed to evaluate the utility of a pretransplantation vaccine and infusion of a primed autologous T-cell product in stimulating specific immunity to influenza. Twenty-one patients with multiple myeloma were enrolled from 2007 to 2009. Patients were randomly assigned to receive an influenza-primed autologous T-cell product or a nonspecifically primed autologous T-cell product. The study endpoint was the development of hemagglutination inhibition titers to the strain-specific serotypes in the influenza vaccine. Enzyme-linked immunospot assays were performed to confirm the development of influenza-specific B-cell and T-cell immunity. Patients who received the influenza-primed autologous T-cell product were significantly more likely to seroconvert in response to the influenza vaccine (P = .001). Seroconversion was accompanied by a significant B-cell response. No differences were observed in the global quantitative recovery of T-cell and B-cell subsets or in global T-cell and B-cell function. The provision of a primed autologous T-cell product significantly improved subsequent influenza vaccine responses. This trial was registered at www.clinicaltrials.gov as #NCT00499577.
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Source: PubMed