Response to immunization against polio after allogeneic marrow transplantation.

Long-term immunity to poliovirus and immunization response to inactivated poliovirus vaccine (IPV) were studied in 55 patients who underwent allogeneic bone marrow transplantation (BMT). Antibodies were determined by neutralization assays. Patients were studied before, at 12 months after BMT and at 12 months after immunization with IPV. Thirty-seven patients were seropositive to all poliovirus types at 12 months after BMT. At least a four-fold decrease in antibody level was recorded between BMT and 12 months later in 55%, 41%, and in 45% of the patients to poliovirus types 1, 2, and 3, respectively. Nineteen patients were immunized with one dose of trivalent IPV. Eight patients (42%), seven patients (36%), and four patients (21%) responded with at least a four-fold antibody titer increase to poliovirus type 1, 2, and 3, respectively. Twenty-nine patients were primarily immunized with three IPV doses. The response rates were 52%, 48% and 48% to poliovirus types 1, 2, and 3, respectively. The immunization responses were similar in patients who did or did not have chronic GVHD. Reimmunization of allogeneic BMT recipients against poliovirus is necessary and a three dose schedule is needed to obtain an adequate immunization response.