Differential Antibody Response To Polysaccharide Vaccines Following Allogeneic Stem Cell Transplantation; A Dynamical Systems Perspective

Bacterial polysaccharide vaccination is generally commenced within 6 months to 1 year following SCT. Antibody responses to these vaccines tend to be variable, raising concerns for inadequate protection from infection and the potential for repeated vaccination. This landmark analysis was performed to evaluate pathogen specific antibody titers, as well as helper T cell and B cell recovery from transplant and post-vaccination amongst patients surviving at least 6 months post allogeneic SCT. Antibody titers to various pneumococcal serotypes and Hemophilus influenza type B (HiB) followed a Power Law distribution in each individual at all time points evaluated. Distinct serotype vaccine responses were observed and antibody titer hierarchy developed early after vaccination and was maintained over time. When B cell recovery was modeled as a function of helper T cell reconstitution over time, the robustness of the antibody response was dependent on threshold values of cellular immune recovery. These suggest that antibody responses are a highly regulated dynamical system.