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Table 7 Responses to vaccination in alemtuzumab (ALEM) and control cohorts (CON)against diphtheria, tetanus, polio virus (P1-P3), pneumococcal antigen and influenza

From: Immune reconstitution 20 years after treatment with alemtuzumab in a rheumatoid arthritis cohort: implications for lymphocyte depleting therapies

  Diphtheria toxoid Tetanus Toxoid Poliovirus   
P1 P2 P3 Pneumococcus antigen
Alem (n = 6) Controls (n = 4) Alem (n = 6) Con (n = 4) Alem (n = 6) Con (n = 4) Alem (n = 6) Con (n = 4) Alem (n = 6) Con (n = 4) Alem (n = 7) Con (n = 6)
Seroprotection rate, % 66 25 100 100 100 100 83.3 100 83.3 100 _
Seroconversion rate, % 33 25 66.7 50 50 100 16.6 100 83.3 100
% Satisfactory response _ 66 0
Influenza vaccine titres A/Cal/7/09 A/Texas/50/12 B/Mass/02/12     
Alem Con Alem Con Alem Con     
Patients vaccinated at interview Alem n = 4
Controls, n = 3
GMT pre-vaccination 2.92 4.82 3.27 5.96 1.88 2.74     
GMT post-vaccination 3.42 5.16 3.53 6.17 1.98 2.61     
Seroconversion factor 1.16 1.07 1.08 1.03 1.05 0.85     
Seroprotection rate, % 50 66.7 50 100 25 33.3     
Seroconversion rate, % 25 0 0 0 0 0     
Alem* n = 9
Controls* n = 8
Seroprotection rate, % 22 87.5 56 87.5 11 37.5     
  1. Tetanus and diphtheria seroprotection was achieved when respective IgG titres were >1.0 IU/ml and seroconversion was defined as new seroprotection. For polio subtypes (P1-P3) seroprotection was a neutralizing antibody titre of ≥1:8 and seroconversion a ≥ fourfold increase in titres. Satisfactory response for pneumococcal antigen was defined as a twofold or more increase from vaccination baseline in antibody concentrations in six or more of 12 pneumococcal serotypes (1, 3, 4, 5, 6B, 7 F, 9 V, 14, 19A, 19 F, 23 F and 18C). For influenza haemagglutination inhibition (HAI) titres >1:40 were defined as seroprotective and seroconversion was defined as rises from negative titres to values of =/>1:40 (or fourfold titre increase if values were above baseline). Seroconversion factor was defined as the fold increase in geometric mean HAI titres (GMT) post-vaccination (recommended ≥2) and seroconversion rate the percentage of vaccines with an increase in HAI titre ≥ fourfold following vaccination (recommended >30%). Seroprotection rate (for all) was defined as percentage of group achieving seroprotection. *Including patients who had influenza vaccine out with this study period