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The Quantification of Antigen-Specific Antibody Sequence (QASAS) method enables real-time assessment of responses to SARS-CoV-2 antigen exposure through B-cell receptor (BCR) repertoire analysis. Using this method, we evaluated the disappearance of immunological memory after HSCT. First, in individuals without hematologic disorders, primary SARS-CoV-2 antigen exposure elicited no immune response at 7\u00a0days post-exposure but demonstrated activation between 14 to 21\u00a0days. In contrast, repeated exposure elicited early responses (secondary immune responses) at 7\u00a0days post-exposure. We then enrolled HSCT patients with pre-HSCT SARS-CoV-2 antigen exposure history and collected samples before and after vaccination. Despite prior exposure history, patients receiving their first vaccination after HSCT showed no response around 7\u00a0days post-exposure but responded at 14\u00a0days. In conclusion, even with pre-HSCT antigen exposure, the first vaccination after HSCT induced a primary immune response. This demonstrates that first vaccination after HSCT should be considered to induce a primary immune response, regardless of previous infection or vaccination history.<\/jats:p>","DOI":"10.1007\/s12185-025-04042-9","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T13:20:35Z","timestamp":1753449635000},"page":"877-884","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Humoral immunity after hematopoietic stem cell transplantation: evaluation by B-cell receptor repertoire analysis"],"prefix":"10.1007","volume":"122","author":[{"given":"Sakuya","family":"Matsumoto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7793-5013","authenticated-orcid":false,"given":"Yohei","family":"Funakoshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimikazu","family":"Yakushijin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takaji","family":"Matsutani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuri","family":"Okazoe-Hirakawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goh","family":"Ohji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taiji","family":"Koyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiaki","family":"Nagatani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiji","family":"Kurata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiro","family":"Kimbara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Kiyota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hironobu","family":"Minami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"key":"4042_CR1","doi-asserted-by":"publisher","first-page":"1813","DOI":"10.1056\/NEJMra052638","volume":"354","author":"EA Copelan","year":"2006","unstructured":"Copelan EA. Hematopoietic stem-cell transplantation. N Engl J Med. 2006;354:1813\u201326.","journal-title":"N Engl J Med"},{"key":"4042_CR2","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.3324\/haematol.2021.279189","volume":"107","author":"D Niederwieser","year":"2022","unstructured":"Niederwieser D, Baldomero H, Bazuaye N, Bupp C, Chaudhri N, Corbacioglu S, et al. One and a half million hematopoietic stem cell transplants: continuous and differential improvement in worldwide access with the use of non-identical family donors. Haematologica. 2022;107:1045\u201353.","journal-title":"Haematologica"},{"key":"4042_CR3","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2016.00507","volume":"7","author":"J Ogonek","year":"2016","unstructured":"Ogonek J, Kralj Juric M, Ghimire S, Varanasi PR, Holler E, Greinix H, et al. Immune reconstitution after allogeneic hematopoietic stem cell transplantation. 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T.M. was an employee of Repertoire Genesis Inc. H.M. has received research grants and honoraria from Daiichi-Sankyo. The other authors declare no potential conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was conducted in accordance with the principles of the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All participants provided written informed consent for this research.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The study protocol was approved by Kobe University Hospital Ethics Committee (No. B2356701 and 1481).","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trial registration number"}}]}}