Donor-Derived Humoral Immunity, Hematopoietic Stem Cell Transplantation, TAR

To participate in this study, patients will need to have given informed consent to have a bone marrow transplant. Before receiving the tetanus vaccine, we would like to test the patient's immune system against tetanus. We will again want to test the patient's immune system against tetanus on the day the patient receives the bone marrow transplant. Approximately 3 months after transplant, if the patient is still eligible, they will receive an additional tetanus booster shot. We will again draw blood to test their immune system against tetanus at the time points listed below.

TREATMENT PLAN:

If the subject meets eligibility requirements and consents to be part of this study, we will collect 8 mL (1.7 teaspoons) of blood from the subject to test their immunity 7 to 10 days before their bone marrow transplant. The subject will receive a tetanus vaccine (given as an injection into the upper arm or thigh muscle) on that same day. We will then collect approximately the same amount of blood (2 teaspoons) on the day the patient would receive the bone marrow transplant. We will also collect the same amount of blood 1 week, 2 weeks, 4 weeks and 3 months, 6 months and 12 months after the transplant. This will help us to see how the patients immune system responded to the vaccine.

Three months after the transplant, the patient will receive an additional tetanus vaccine (known as a booster shot), but only if the patient is still eligible to receive it. Patient's will only be eligible to receive the booster shot if they remain well and do not have any other problems such as severe infection, graft versus host disease or relapse. We will collect 8 ml (1.7 teaspoons) of blood 1 week, 2 weeks and 4 weeks after receiving the booster shot to determine if they respond to the vaccine.

Inclusion criteria

Inclusion criteria

for Donors:

• Related donor of bone marrow or peripheral blood stem cell product
• Age 3 to 70 years
• Informed consent form signed and sent to Research Coordinator

Inclusion criteria

for Recipients:

• Patient with acute lymphoblastic leukemia, acute myelogenous leukemia, chronic myelogenous leukemia, myelodysplastic syndrome, myeloproliferative disorder, Hodgkin lymphoma, non-Hodgkin lymphoma, or a non-malignant disease requiring allogeneic stem cell transplant
• Age between 3 and 70 years
• Informed consent form signed and sent to Research Coordinator

Exclusion criteria

Exclusion criteria

for Donors:

• Allergy to tetanus vaccine
• Pregnant or lactating
• Has received tetanus booster within preceding 12 months

Exclusion criteria

for Recipients to Receive FIRST Tetanus Immunization:

• Allergy to tetanus vaccine
• Has received tetanus booster within preceding 12 months
• Has active malignancy (not in remission)

Exclusion criteria

for Recipients to Receive SUBSEQUENT Tetanus Immunization:

• Allergy to tetanus vaccine
• Active, acute graft vs. host disease (GVHD) greater than or equal to grade II or chronic graft vs. host disease (GVHD)
• Disease relapse - less than 75% donor chimerism (peripheral blood or bone marrow)
• Active infection (bacterial, viral, fungal) or fever (temperature greater than 100.5 celsius)