Evidence map›Paper›PMID 41012135›Full record

ReviewVaccines2025

Immunization Strategies in Pediatric Patients Receiving Hematopoietic Cell Transplantation (HCT) and Chimeric Antigen Receptor T-Cell (CAR-T) Therapy: Challenges and Insights from a Narrative Review.

Daniele Zama, Laura Pedretti, Gaia Capoferri, Roberta Forestiero, Marcello Lanari, Susanna Esposito

Abstract readReview
In one paragraph

Review in Vaccines, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Daniele ZamaPediatric Emergency Unit, IRCCS, Azienda Ospedaliera Universitaria di Bologna, 40138 Bologna, Italy.ORCID 0000-0002-9895-5942
Laura PedrettiPediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.
Gaia CapoferriPediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.
Roberta ForestieroPediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.
Marcello LanariPediatric Emergency Unit, IRCCS, Azienda Ospedaliera Universitaria di Bologna, 40138 Bologna, Italy.
Susanna EspositoPediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.ORCID 0000-0003-4103-2837

Funding

NextGenerationEU CUP I83C22001810007
6 · The paper itself

Abstract

backgroundHematopoietic cell transplantation (HCT) and chimeric antigen receptor T-cell (CAR-T) therapy have markedly improved survival in pediatric patients with hematological malignancies. However, these treatments cause profound immunosuppression, leading to significant susceptibility to vaccine-preventable diseases (VPDs), including invasive pneumococcal disease and measles. Timely and tailored immunization strategies are crucial to mitigate infectious risks in this vulnerable population.

methodsWe conducted a narrative review of the English-language literature from 2000 to 2024, including clinical guidelines, surveys, and original studies, to evaluate immune reconstitution and vaccination practices in pediatric patients undergoing HCT and CAR-T therapy. Literature searches in PubMed, Scopus, and Web of Science used disease-specific, therapy-specific, and pathogen-specific terms. Data synthesis focused on vaccine schedules, immune recovery markers, and adherence challenges.

resultsProfound immune deficits post-HCT and CAR-T therapy compromise both innate and adaptive immunity, often necessitating revaccination. Key factors influencing vaccine responses include time since therapy, graft source, immunosuppressive treatments, and chronic graft-versus-host disease. Although inactivated vaccines are generally safe from three to six months post-HCT, live vaccines remain contraindicated until documented immune recovery. CAR-T therapy introduces unique challenges due to prolonged B-cell aplasia and hypogammaglobulinemia, leading to delayed or reduced vaccine responses. Despite established guidelines, real-world adherence to vaccination schedules remains suboptimal, driven by institutional, logistic, and patient-related barriers.

conclusionsEffective vaccination strategies are essential for reducing infectious morbidity in pediatric HCT and CAR-T recipients. Personalized vaccine schedules, immune monitoring, and multidisciplinary coordination are critical to bridging gaps between guidelines and practice, ultimately improving long-term outcomes for immunocompromised children.

Indexed as

CAR-T therapyhematopoietic cell transplantationimmunization strategiesimmunocompromised childrenpediatric infectious diseasesvaccine-preventable diseases

Identifiers

PMID41012135
PMCPMC12474115

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.