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Impaired Antibody Response to Pneumococcal Vaccine after Treatment for Hodgkin's Disease
Abstract
To determine if a normal antibody response can develop after therapy for Hodgkin's disease, we immunized 53 patients and 10 normal controls with dodecavalent pneumococcal vaccine. Antibody concentrations three weeks after immunization (geometric mean of 11 serotypes) were 1566 ng of protein nitrogen per milliliter in controls, 963 ng per milliliter after subtotal radiation (P less than 0.05 compared to controls), 658 ng per milliliter after chemotherapy (P less than 0.05), 377 ng per milliliter after subtotal radiation plus chemotherapy (P less than 0.01) and 283 ng per milliliter after total nodal radiation plus chemotherapy (P less 0.001). Low levels of antibody before immunization correlated with a poor response (r = +0.73, P less than 0.001). The ability to respond to immunization improved significantly but did not return to normal as long as four years after combined therapy. The antibody response to pneumococcal vaccine is profoundly impaired in patients who have received intensive treatment for Hodgkin's disease: the ability of this vaccine to protect them from overwhelming postsplenectomy infections remains in doubt.
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Cited by
2013 IDSA Clinical Practice Guideline for Vaccination of the Immunocompromised Host
Rubin, L. G., Levin, M. J., Ljungman, P., Davies, E. G., Avery, R., Tomblyn, M., Bousvaros, A., Dhanireddy, S., Sung, L., Keyserling, H., et al. (2014) · Clinical Infectious Diseases · doi:10.1093/cid/cit684 · Cited by 1,613
Power and Sample Size Calculations for Studies Involving Linear Regression
Dupont, W. D., & Plummer, W. D. (1998) · Controlled Clinical Trials · doi:10.1016/s0197-2456(98)00037-3 · Cited by 1,024
Siber, G. R., Schur, P. H., Aisenberg, A. C., Weitzman, S. A., & Schiffman, G. (1980) · New England Journal of Medicine · doi:10.1056/nejm198007243030402 · Cited by 473
Self-citationMassarweh, A., Eliakim-Raz, N., Stemmer, A., Levy-Barda, A., Yust-Katz, S., Zer, A., Benouaich-Amiel, A., Ben-Zvi, H., Moskovits, N., Brenner, B., et al. (2021) · JAMA Oncology · doi:10.1001/jamaoncol.2021.2155 · Cited by 265
Host Defense Against Streptococcus pneumoniae: The Role of the Spleen
Wara, D. W. (1981) · Clinical Infectious Diseases · doi:10.1093/clinids/3.2.299 · Cited by 84
Metadata
- Authors
- Siber, G. R., Weitzman, S. A., Aisenberg, A. C., Weinstein, H. J., & Schiffman, G.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1978-08-31
- Volume
- 299
- Issue
- 9
- Pages
- 442-448
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2341375170
- Cited by
- 210
- References
- 0
- FWCI
- 12.41
- Type
- journal article
- Language
- en
- Open access
- closed
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- CoChat. (2026). Citation check: Impaired Antibody Response to Pneumococcal Vaccine after Treatment for Hodgkin's Disease. https://app.cochat.ai/papers/10.1056/nejm197808312990903
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- Siber, G. R., Weitzman, S. A., Aisenberg, A. C., Weinstein, H. J., & Schiffman, G. (1978). Impaired Antibody Response to Pneumococcal Vaccine after Treatment for Hodgkin's Disease. New England Journal of Medicine. https://doi.org/10.1056/nejm197808312990903
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