감염

BACKGROUND: Bone marrow transplantation (BMT) has become a significant treatment modality for hematopoietic and solid organ malignancy. Recipients of BMTs lose immunity to measles-mumps-rubella (MMR) and hepatitis B infections which are preventable with vaccination. There is no consensus regarding a vaccination schedule after BMT and time of vaccination is variable according to each institution. We analyzed sequential changes in antibody titers of MMR and hepatitis B during the first year after BMT in an attempt to identify the time, dose, and needs for revaccination. METHODS: Total 20 patients with hematologic malignancies were studied. Serum levels of IgG antibodies of MMR and hepatitis B virus (HBV) were determined every three months post-BMT by enzyme immunoassay (EIA), chemical luminescence immunoassay (CLIA) and immunofluorescence assay (IFA). RESULTS: IgG antibody levels of measles, rubella, HBV were 1:746, 80 85 IU/mL, 214 343 IU/L before BMT, declined to 1:633, 18 11 IU/mL, 4 6 IU/L one year after BMT, respectively. All the antibody levels were still above cut-off value for positive immunity. Mumps antibody titers were 1:62 before BMT, declined to 1:25 significantly from 6 months after BMT, but the antibody level was still above cut-off value. CONCLUSION: Antibody titers of MMR and hepatitis B decline during the first year after BMT, but the levels are still above cut-off value. Thus, the timing of revaccination should be after the first year post-transplantation. Long-term studies are needed to determine the optimal time for revaccination.