[en] Over the past years, hematopoietic stem cell transplantation (HSCT) is increasingly used as a consolidation therapy in several haematological diseases and solid tumours. In the post-transplantation period, the immunity of HSCT recipients is impaired due to toxicity of the pre-HSCT treatment (chemo- and/or radiotherapy) and the conditioning regimen with reset of the immune system and – in case of allogeneic stem cell transplantation – possible graft-versus-host-disease (GVHD) and use of immunosuppressive drugs. This leads to a considerably increased risk of infections, with higher morbidity and mortality in these patients. Therefore, prevention of
infections, through antibiotic prophylaxis, life style adjustments, germfree nutrition and revaccination, is of major importance to improve outcomes.
In this article we present the Belgian guidelines for vaccination after hematopoietic stem cell transplantation, based on available data in the literature and international guidelines, taking into account the availability of vaccines and - if applicable - their reimbursement in Belgium. We present a general vaccination schedule for post-HSCT patients, a proposition for pre-transplant vaccination and donor vaccination, and an overview of special indications such as travel vaccinations and vaccinations of close contacts and health care workers, with guidelines for titer follow up.
