Requiring Immunization After Rescue Autologous HSCT

Patients with successful autologous or allogeneic hematopoietic stem-cell therapy should get booster courses of previous vaccinations Additionally, the patient should get inactivated Inf, PCV and Men vaccine Inactivated vaccines can generally be started at 6 months post HSCT, provided the child has no immunosuppression for the past 3 months, a lymphocyte count >1200/μL, and endogenous IgG > 500 mg/dL Live vaccines are strictly contraindicated. Only MMR and Var can be considered in select well engrafted cases, no sooner than 24 months after HSCT. Requirement is CD4+ count >700/mL, endogenous IgG >500 mg/dL, and adequate serological response to inactivated vaccines, no immunosuppression and no GVHD Passive immunoglobulin prophylaxis is established for measles by IVIG and for chickenpox by VZIG Chemoprophylaxis with valacyclovir is available for chickenpox, in intramuscular and subcutaneous forms The 16% HNIG concentrate can provide passive protection for measles, and to some extent hepatitis A and chickenpox