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Response of Patients with Hodgkin's Disease to Pneumococcal Vaccine

DAVID R. MINOR, M.D.; GERALD SCHIFFMAN, Ph.D.; and LINDA SUE McINTOSH, M.D.
[+] Article and Author Information

This research was supported in part by the Veterans Administration, National Cancer Institute grants CA 08341 and CA 09200, and National Institute of Allergy and Infectious Disease grant A1-42541.

▸Requests for reprints should be addressed to David R. Minor, M.D.; Suite 330, 909 Hyde Street; San Francisco, CA 94109.


© 1979 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1979;90(6):887-892. doi:10.7326/0003-4819-90-6-887
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Postsplenectomy, 41 patients previously treated for Hodgkin's disease were given pneumococcal vaccine, and type-specific antibody levels were measured before and after immunization. Postimmunization antibody levels in patients with Hodgkin's disease were significantly lower than those in normal control subjects for 10 of the 12 serotypes measured. Mean postimmunization antibody level for patients (587 ± 427 ng of antibody nitrogen/mL) was much lower than that for control subjects (1787 ± 694). Antibody levels tended to increase with time from therapy for Hodgkin's disease, and several patients who had not received therapy for more than 3 years had normal responses to immunization. Despite vaccination, one patient developed pneumococcal meningitis and another, pneumococcal bacteremia. Both infected patients had low postimmunization mean antibody levels (282 and 137 ng/mL, respectively). Postsplenectomy sepsis in patients with Hodgkin's disease is related to a humoral immune deficiency probably induced by radiation and chemotherapy, and this immune deficiency persists for several years.

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