IMMUNITY TO POLIOVIRUS AND IMMUNIZATION WITH INACTIVATED POLIOVIRUS VACCINE AFTER AUTOLOGOUS BONE-MARROW TRANSPLANTATION

Titers of antibody to poliovirus in 102 patients were determined with a sensitive neutralization assay before and 1 year after autologous bo ne marrow transplantation. At 1 year 14 patients (14%) had lost antibo dies to poliovirus type 1 (P < .001), 10 (10%) to poliovirus type 2 (P < .05), and 13 (13%) to poliovirus type 3 (P < .01). Twenty-two patie nts had lost antibodies to at least one type of poliovirus. Follow-up of unimmunized patients 2 years (n = 40) and 3 years (n = 23) after tr ansplantation documented a continuous decrease in antibody titer; by 3 years after transplantation, another 6 patients had become seronegati ve. When one dose of inactivated trivalent poliovirus vaccine was admi nistered 1 year after transplantation, 2 (25%) of 8 patients seronegat ive for poliovirus type 1 had an increase of at least fourfold in anti body titer; after three doses, 10 (83%) of 12 patients exhibited such an increase (P < .05). The corresponding figures were 5 (71%) of 7 and 13 (100%) of 13 for poliovirus type 2 (difference not significantly) and 2 (22%) of 9 and 14 (88%) of 16 for poliovirus type 3 (P < .01). T hese results indicate that at least 30% of patients undergoing autolog ous bone marrow transplantation including those seronegative for polio virus before transplantation will benefit from reimmunization with thr ee doses of inactivated trivalent poliovirus vaccine 1 year after tran splantation.