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Antibody Response to Pretreatment Immunization and Post-treatment Boosting with Bacterial Polysaccharide Vaccines in Patients with Hodgkin's Disease

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Grant support: in part by grants P01-CA-19589, AI-026467, and AI-18125 of the National Institutes of Health and MV55 of the American Cancer Society.

▸Requests for reprints should be addressed to George R. Siber, M.D.; Director, Massachusetts Public Health Biologic Laboratories, 305 South Street; Jamaica Plain, MA 02130.

Boston, Jamaica Plain, and Burlington, Massachusetts; and Brooklyn, New York

©1986 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1986;104(4):467-475. doi:10.7326/0003-4819-104-4-467
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Overwhelming sepsis is a serious complication of staging splenectomy in Hodgkin's disease. To define an optimal immunization strategy, 51 patients received 14-valent pneumococcal, Haemophilus influenzae type b, and meningococcal group C vaccines before therapy and 2 to 12 months after completion of therapy. Natural antibody levels to bacterial polysaccharide antigens and the response to immunization were normal or only minimally impaired in patients with Hodgkin's disease compared with findings in healthy adults. The antibody response was not affected by the timing of immunization relative to splenectomy but was frequently impaired if chemotherapy was begun less than 10 days after immunization. Both post-immunization and "natural" antibody declines were significantly greater in patients with Hodgkin's disease than in healthy adults; the magnitude of the decline was related to the intensity of therapy. A spontaneous rebound in antibody concentrations was not seen during the 12 months after treatment. Booster immunizations of all three vaccines given during this period also failed to elicit an antibody increase.





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