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Existen diferentes evidencias de la desaparición de inmunidad frente a las enfermedades para las que existe inmunoprofilaxis activa, tras un trasplante alogénico de medula ósea. Estos hallazgos no constituyen sólo un problema epidemiológico. Desde un punto de vista estrictamente clínico, estos pacientes podrían beneficiarse de la administración de determinadas formas de vacunas frente a enfermedades a las que son especialmente susceptibles. Sin embargo, no existe en la actualidad una pauta unificada para la revacunación de estos pacientes. Más aún, diferentes encuestas sugieren que la inmunoprofilaxis activa es con frecuencia infravalorada en estos pacientes.
En la presente revisión, se pretende ofrecer tanto una información actualizada sobre las actuales tendencias, omo una guía práctica para la reinmunización de estos pacientes de acuerdo con las necesidades de nuestro medio.
Palabras clave:
Trasplante de medula ósea
Vacuna
Inmunoprofilaxis
Calendario vacunal
Enfermedades infecciosas
Niños
Adolescentes
Lactante
Enfermedad de injerto contra huésped
There is considerable evidence supporting the disappearance of immunity against diseases for which there is active immune-prophylaxis available after allogeneic hematopoietic progenitor cell transplantation. These findings do not constitute merely an epidemiologic problem. From a strictly clinical point of view, these patients might benefit from the administration of different forms of vaccines against diseases to which they are particularly susceptible. There are, however, no unified criteria for the revaccination of these patients. Moreover, several surveys suggest that active immune-prophylaxis is frequently undervalued in these patients. In the present review, we provide up-to-date information on current trends as well as practical guidelines for the re-immunization of these patients in our environment.
Key words:
Bone marrow transplantation
Vaccine
Immunoprophylaxis
Immunization schedule
Infectious diseases
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