We spend a lifetime acquiring natural immunity against colds and viruses. So what happens to those antibodies after a stem cell transplant?
I remember getting a lot of viruses from my kids when they were young. Will the transplant obliterate this immunity? Will we have to start over? Same question for artificial immunity (i.e., vaccines).
Thank you!
Forums
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gardengirl - Name: gardengirl
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Nov. 2013
- Age at diagnosis: 47
Re: What happens to our acquired immunity after SCT?
Gardengirl-
The doctors seem to disagree with one another on the issue of antibodies post transplant. My oncologist says that we maintain our antibodies post transplant because we are getting our own stem cells back in an ASCT. He doesn't feel that it is necessary to be reimmunized post transplant. Many other oncologists have all of their patients get reimmunized.
I developed a number of respiratory infections during the first year post transplant. But I haven't had any respiratory, or other, infections since then. I had my transplant 5 1/2 years ago.
Nancy in Phila
The doctors seem to disagree with one another on the issue of antibodies post transplant. My oncologist says that we maintain our antibodies post transplant because we are getting our own stem cells back in an ASCT. He doesn't feel that it is necessary to be reimmunized post transplant. Many other oncologists have all of their patients get reimmunized.
I developed a number of respiratory infections during the first year post transplant. But I haven't had any respiratory, or other, infections since then. I had my transplant 5 1/2 years ago.
Nancy in Phila
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NStewart - Name: Nancy Stewart
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 3/08
- Age at diagnosis: 60
Re: What happens to our acquired immunity after SCT?
And my oncologist is in the opposite camp from Nancy's. 
I've gotten a full course of vaccinations beginning 1 year post-SCT.
For more discussion about this topic, see https://myelomabeacon.org/forum/one-year-post-transplant-immunization-t4415.html
So this is a good question to ask your oncologist, Gardengirl. Let us know which camp s/he is in!
Mike
I've gotten a full course of vaccinations beginning 1 year post-SCT.
For more discussion about this topic, see https://myelomabeacon.org/forum/one-year-post-transplant-immunization-t4415.html
So this is a good question to ask your oncologist, Gardengirl. Let us know which camp s/he is in!
Mike
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mikeb - Name: mikeb
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 2009 (MGUS at that time)
- Age at diagnosis: 55
Re: What happens to our acquired immunity after SCT?
Hello Garden Girl:
Only because we discussed with the doctors, I will add on a little to the comments offered above. Here it is to the best of my recollection. The word the doctor used post transplant was that the new immune system is "naïve". There is a measurement that they can take to see how much your immune system remembered the pre-transplant condition. Others have posted this, but its called the "titers".
If you measure the titers, my understanding is as follows. It varies from patient to patient. It is very very rare that you retain all pre-transplant immunity, but possible. The most likely result is that you retain a small fraction of the pre-transplant immunity, but it might also be zero. Accordingly, I understand in the majority of patients, where the measure the titers, the approach is that all childhood vaccines are re-administered about a year later.
I think that it is a very rare thing for patients to contract a childhood virus before he/she is re-vaccinated, but it is prudent to do so at the right time, because it is something that would be very unpleasant to deal with. Good luck.
Only because we discussed with the doctors, I will add on a little to the comments offered above. Here it is to the best of my recollection. The word the doctor used post transplant was that the new immune system is "naïve". There is a measurement that they can take to see how much your immune system remembered the pre-transplant condition. Others have posted this, but its called the "titers".
If you measure the titers, my understanding is as follows. It varies from patient to patient. It is very very rare that you retain all pre-transplant immunity, but possible. The most likely result is that you retain a small fraction of the pre-transplant immunity, but it might also be zero. Accordingly, I understand in the majority of patients, where the measure the titers, the approach is that all childhood vaccines are re-administered about a year later.
I think that it is a very rare thing for patients to contract a childhood virus before he/she is re-vaccinated, but it is prudent to do so at the right time, because it is something that would be very unpleasant to deal with. Good luck.
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JPC - Name: JPC
Re: What happens to our acquired immunity after SCT?
And, just to add one more thing to JPC's very good explanation.
It is my understanding that each of the titers measures one antibody only. So a post-transplant patient might have some titers that are in the normal range and some that are below normal, which would require re-vaccination. For example, in my case the measles titer was in the normal range (perhaps because I had a pretty severe cases of measles as a child), but most others were below normal.
Mike
It is my understanding that each of the titers measures one antibody only. So a post-transplant patient might have some titers that are in the normal range and some that are below normal, which would require re-vaccination. For example, in my case the measles titer was in the normal range (perhaps because I had a pretty severe cases of measles as a child), but most others were below normal.
Mike
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mikeb - Name: mikeb
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 2009 (MGUS at that time)
- Age at diagnosis: 55
Re: What happens to our acquired immunity after SCT?
My husband has a transplant about 5 years ago. He did not need to get the hepatitis a and b vaccination because it still showed that he was immune to that. However, he did get the whooping cough about 9 months after the transplant.
Re: What happens to our acquired immunity after SCT?
After a transplant, it's gone. That's why you have to re-vaccinate. You start from scratch.
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Joneman
Re: What happens to our acquired immunity after SCT?
As many have mentioned ... it depends, and it varies.
As for me, I had measles when I was eight ... and darned near died of 'em. For some reason, I got a bee in my bonnet over it when 'they' were counting up the vaccinations they wanted me to have ('they" being my oncologists). I just felt that, darn it, before they gave me a shot, they should find out if I actually NEEDED one.
And it turns out that I don't. I'm still immune to measles. However, I was not immune to pertussis or some of the other things, so (rubbing left arm ruefully) I got the lot.
Except for measles.
So ... why am I rubbing my left arm? Because I saw my transplant doc today, almost exactly two years post transplant, and he nailed me with three more of 'em.
Well, OK. So I won't get the flu this year, or pneumonia, or whooping cough or measles or chicken pox or a whole host of other things. This is good.
As for me, I had measles when I was eight ... and darned near died of 'em. For some reason, I got a bee in my bonnet over it when 'they' were counting up the vaccinations they wanted me to have ('they" being my oncologists). I just felt that, darn it, before they gave me a shot, they should find out if I actually NEEDED one.
And it turns out that I don't. I'm still immune to measles. However, I was not immune to pertussis or some of the other things, so (rubbing left arm ruefully) I got the lot.
Except for measles.
So ... why am I rubbing my left arm? Because I saw my transplant doc today, almost exactly two years post transplant, and he nailed me with three more of 'em.
Well, OK. So I won't get the flu this year, or pneumonia, or whooping cough or measles or chicken pox or a whole host of other things. This is good.
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dianaiad - Who do you know with myeloma?: Me
- When were you/they diagnosed?: Officially...March 2013
- Age at diagnosis: 63
Re: What happens to our acquired immunity after SCT?
Hey mikeb,
My doctor is in both camps! He said I will get re-vaccinated some time post-transplant. And as far as the acquired immunity, he feels I will get some of it back during the re-infusion. I was most concerned about the acquired immunity since I worked so hard to get it; would hate to loose it completely!
P.S. I find it odd that my entire family was sick a few weeks ago and the immunocompromised one here did not get even a sniffle!
My doctor is in both camps! He said I will get re-vaccinated some time post-transplant. And as far as the acquired immunity, he feels I will get some of it back during the re-infusion. I was most concerned about the acquired immunity since I worked so hard to get it; would hate to loose it completely!
P.S. I find it odd that my entire family was sick a few weeks ago and the immunocompromised one here did not get even a sniffle!
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gardengirl - Name: gardengirl
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Nov. 2013
- Age at diagnosis: 47
Re: What happens to our acquired immunity after SCT?
I had my stem cell transplant at Johns Hopkins. They told me to get re-vaccinated.
My home oncologist gave me a re-vaccination protocol, which I shared with my general practitioner, and we followed exactly. The last vaccine was for chicken pox, followed by testing to see if I had any anti-bodies. None.
So my oncologist and I decided to wait at least a year before trying again, to let my system mature -- or, as someone noted, to stop being "naive." Well, I haven't exactly gotten around to it, although I get flu shots every year. I did get shingles a year ago, so I know I still have chicken pox virus in me. Maybe I'll finally make the time to get vaccines again.
Dana A
My home oncologist gave me a re-vaccination protocol, which I shared with my general practitioner, and we followed exactly. The last vaccine was for chicken pox, followed by testing to see if I had any anti-bodies. None.
So my oncologist and I decided to wait at least a year before trying again, to let my system mature -- or, as someone noted, to stop being "naive." Well, I haven't exactly gotten around to it, although I get flu shots every year. I did get shingles a year ago, so I know I still have chicken pox virus in me. Maybe I'll finally make the time to get vaccines again.
Dana A
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darnold - Name: Dana Arnold
- Who do you know with myeloma?: self
- When were you/they diagnosed?: May 2009
- Age at diagnosis: 52
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