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. 1997 Nov;4(6):635–638. doi: 10.1128/cdli.4.6.635-638.1997

Antibody responses of splenectomized patients with non-Hodgkin's lymphoma to immunization with polyvalent pneumococcal vaccines.

S Petrasch 1, O Kühnemund 1, A Reinacher 1, M Uppenkamp 1, R Reinert 1, W Schmiegel 1, R Lütticken 1, G Brittinger 1
PMCID: PMC170631  PMID: 9384280

Abstract

The serum antibody responses of splenectomized patients with non-Hodgkin's lymphoma (NHL) who had been immunized with a polyvalent pneumococcal vaccine (Pneumovax 23) were evaluated by an enzyme-linked immunosorbent assay with the 23-valent pneumococcal vaccine as the antigen. A response to immunization, defined as a twofold-or-higher rise of the prevaccination titer of antibodies against Streptococcus pneumoniae polysaccharide, was elicited in 5 of 11 patients with NHL. No significant difference in the level of antibodies against S. pneumoniae polysaccharide between lymphoma patients and patients who had undergone splenectomy for other reasons was detected (P = 0.83 and 0.87 before and after vaccination, respectively). NHL patients who did not respond to the first immunization received a booster dose of the polysaccharide vaccine. This injection did not increase the pneumococcal-antibody titer significantly (P = 0.7). We conclude that vaccination with pneumococcal polysaccharides in splenectomized patients with NHL elicits an adequate antibody response in 45.4% of the cases and should therefore be administered. Revaccination of the nonresponders does not further increase the pneumococcal-antibody levels.

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Selected References

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  1. Aaberge I. S., Heier H. E. Long-term effect of pneumococcal polysaccharide vaccination on serum IgM and IgG antibody levels in individuals splenectomized for trauma. Acta Pathol Microbiol Immunol Scand C. 1984 Dec;92(6):363–369. doi: 10.1111/j.1699-0463.1984.tb00101.x. [DOI] [PubMed] [Google Scholar]
  2. Addiego J. E., Jr, Ammann A. J., Schiffman G., Baehner R., Higgins G., Hammond D. Response to pneumococcal polysaccharide vaccine in patients with untreated Hodgkin's disease. Children's Cancer Study Group Report. Lancet. 1980 Aug 30;2(8192):450–452. doi: 10.1016/s0140-6736(80)91887-5. [DOI] [PubMed] [Google Scholar]
  3. Amlot P. L., Green L. Serum immunoglobulins G, A, M, D and E concentrations in lymphomas. Br J Cancer. 1979 Sep;40(3):371–379. doi: 10.1038/bjc.1979.191. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Austrian R., Douglas R. M., Schiffman G., Coetzee A. M., Koornhof H. J., Hayden-Smith S., Reid R. D. Prevention of pneumococcal pneumonia by vaccination. Trans Assoc Am Physicians. 1976;89:184–194. [PubMed] [Google Scholar]
  5. Ballester O. F., Shurafa M., Toben H., Kumar K. S., Burek C. L. Impaired antibody responses to a pneumococcal polysaccharide vaccine in patients with non-Hodgkin's lymphoma in remission. J Clin Immunol. 1981 Apr;1(2):90–93. doi: 10.1007/BF00915384. [DOI] [PubMed] [Google Scholar]
  6. Barrett D. J., Triggiani M., Ayoub E. M. Assay of antibody to group A streptococcal carbohydrate by enzyme-linked immunosorbent assay. J Clin Microbiol. 1983 Sep;18(3):622–627. doi: 10.1128/jcm.18.3.622-627.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Borgoño J. M., McLean A. A., Vella P. P., Woodhour A. F., Canepa I., Davidson W. L., Hilleman M. R. Vaccination and revaccination with polyvalent pneumococcal polysaccharide vaccines in adults and infants. Proc Soc Exp Biol Med. 1978 Jan;157(1):148–154. doi: 10.3181/00379727-157-40010. [DOI] [PubMed] [Google Scholar]
  8. Carlson B. A., Giebink G. S., Spika J. S., Gray E. D. Measurement of immunoglobulin G and M antibodies to type 3 pneumococcal capsular polysaccharide by enzyme-linked immunosorbent assay. J Clin Microbiol. 1982 Jul;16(1):63–69. doi: 10.1128/jcm.16.1.63-69.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Caulfield M. J., Shaffer D. A computer program for the evaluation of ELISA data obtained using an automated microtiter plate absorbance reader. J Immunol Methods. 1984 Nov 30;74(2):205–215. doi: 10.1016/0022-1759(84)90288-6. [DOI] [PubMed] [Google Scholar]
  10. Chaikof E. L., McCabe C. J. Fatal overwhelming postsplenectomy infection. Am J Surg. 1985 Apr;149(4):534–539. doi: 10.1016/s0002-9610(85)80052-0. [DOI] [PubMed] [Google Scholar]
  11. Donaldson S. S., Vosti K. L., Berberich F. R., Cox R. S., Kaplan H. S., Schiffman G. Response to pneumococcal vaccine among children with Hodgkin's disease. Rev Infect Dis. 1981 Mar-Apr;3 (Suppl):S133–S143. doi: 10.1093/clinids/3.supplement_1.s133. [DOI] [PubMed] [Google Scholar]
  12. Eby R. Pneumococcal conjugate vaccines. Pharm Biotechnol. 1995;6:695–718. doi: 10.1007/978-1-4615-1823-5_31. [DOI] [PubMed] [Google Scholar]
  13. Frederiksen B., Specht L., Henrichsen J., Pedersen F. K., Pedersen-Bjergaard J. Antibody response to pneumococcal vaccine in patients with early stage Hodgkin's disease. Eur J Haematol. 1989 Jul;43(1):45–49. doi: 10.1111/j.1600-0609.1989.tb01250.x. [DOI] [PubMed] [Google Scholar]
  14. Fuchshuber A., Kühnemund O., Keuth B., Lütticken R., Michalk D., Querfeld U. Pneumococcal vaccine in children and young adults with chronic renal disease. Nephrol Dial Transplant. 1996 Mar;11(3):468–473. [PubMed] [Google Scholar]
  15. Giebink G. S., Foker J. E., Kim Y., Schiffman G. Serum antibody and opsonic responses to vaccination with pneumococcal capsular polysaccharide in normal and splenectomized children. J Infect Dis. 1980 Mar;141(3):404–412. doi: 10.1093/infdis/141.3.404. [DOI] [PubMed] [Google Scholar]
  16. Gopal V., Bisno A. L. Fulminant pneumococcal infections in 'normal' asplenic hosts. Arch Intern Med. 1977 Nov;137(11):1526–1530. [PubMed] [Google Scholar]
  17. Grimfors G., Björkholm M., Hammarström L., Askergren J., Smith C. I., Holm G. Type-specific anti-pneumococcal antibody subclass response to vaccination after splenectomy with special reference to lymphoma patients. Eur J Haematol. 1989 Nov;43(5):404–410. doi: 10.1111/j.1600-0609.1989.tb00327.x. [DOI] [PubMed] [Google Scholar]
  18. Grimfors G., Söderqvist M., Holm G., Lefvert A. K., Björkholm M. A longitudinal study of class and subclass antibody response to pneumococcal vaccination in splenectomized individuals with special reference to patients with Hodgkin's disease. Eur J Haematol. 1990 Aug;45(2):101–108. doi: 10.1111/j.1600-0609.1990.tb00426.x. [DOI] [PubMed] [Google Scholar]
  19. Henrichsen J. Six newly recognized types of Streptococcus pneumoniae. J Clin Microbiol. 1995 Oct;33(10):2759–2762. doi: 10.1128/jcm.33.10.2759-2762.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Jones S. E., Griffith K., Dombrowski P., Gaines J. A. Immunodeficiency in patients with non-Hodgkin lymphomas. Blood. 1977 Mar;49(3):335–344. [PubMed] [Google Scholar]
  21. KAPLAN M. E., COONS A. H., DEANE H. W. Localization of antigen in tissue cells; cellular distribution of pneumococcal polysaccharides types II and III in the mouse. J Exp Med. 1950 Jan 1;91(1):15-30, 4 pl. doi: 10.1084/jem.91.1.15. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Kaufhold A., Lütticken R., Henrichsen J. Capsular types and antibiotic susceptibility of Streptococcus pneumoniae isolated from patients with systemic infections in West Germany. Eur J Clin Microbiol. 1987 Dec;6(6):696–697. doi: 10.1007/BF02013080. [DOI] [PubMed] [Google Scholar]
  23. Levine A. M., Overturf G. D., Field R. F., Holdorf D., Paganini-Hill A., Feinstein D. I. Use and efficacy of pneumococcal vaccine in patients with Hodgkin disease. Blood. 1979 Nov;54(5):1171–1175. [PubMed] [Google Scholar]
  24. Lin K. T., Lee C. J. Immune response of neonates to pneumococcal polysaccharide-protein conjugate. Immunology. 1982 Jun;46(2):333–342. [PMC free article] [PubMed] [Google Scholar]
  25. Molrine D. C., George S., Tarbell N., Mauch P., Diller L., Neuberg D., Shamberger R. C., Anderson E. L., Phillips N. R., Kinsella K. Antibody responses to polysaccharide and polysaccharide-conjugate vaccines after treatment of Hodgkin disease. Ann Intern Med. 1995 Dec 1;123(11):828–834. doi: 10.7326/0003-4819-123-11-199512010-00003. [DOI] [PubMed] [Google Scholar]
  26. Offenbartl K., Christensen P., Gullstrand P., Prellner K., Henrichsen J. Effect of gamma globulin infusion on type-specific pneumococcal antibody levels in splenectomized adults. Int Arch Allergy Appl Immunol. 1986;81(3):209–213. doi: 10.1159/000234136. [DOI] [PubMed] [Google Scholar]
  27. Reinert R. R., Kaufhold A., Kierdorf H. Penicillin-resistant pneumococcus in community-acquired bacteremic pneumonia in Germany. Infection. 1992 Jul-Aug;20(4):238–239. doi: 10.1007/BF02033070. [DOI] [PubMed] [Google Scholar]
  28. Reinert R. R., Kaufhold A., Kühnemund O., Lütticken R. Serum antibody responses to vaccination with 23-valent pneumococcal vaccine in splenectomized patients. Zentralbl Bakteriol. 1994 Nov;281(4):481–490. doi: 10.1016/s0934-8840(11)80335-x. [DOI] [PubMed] [Google Scholar]
  29. Rivilla Parra F., Gámez Aranle M., González Utrilla J. Estudio valorativo de la laparotomía en la enfermedad de Hodgkin. An Esp Pediatr. 1987 Jan;26(1):37–39. [PubMed] [Google Scholar]
  30. Schneerson R., Robbins J. B., Parke J. C., Jr, Bell C., Schlesselman J. J., Sutton A., Wang Z., Schiffman G., Karpas A., Shiloach J. Quantitative and qualitative analyses of serum antibodies elicited in adults by Haemophilus influenzae type b and pneumococcus type 6A capsular polysaccharide-tetanus toxoid conjugates. Infect Immun. 1986 May;52(2):519–528. doi: 10.1128/iai.52.2.519-528.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Shapiro E. D., Berg A. T., Austrian R., Schroeder D., Parcells V., Margolis A., Adair R. K., Clemens J. D. The protective efficacy of polyvalent pneumococcal polysaccharide vaccine. N Engl J Med. 1991 Nov 21;325(21):1453–1460. doi: 10.1056/NEJM199111213252101. [DOI] [PubMed] [Google Scholar]
  32. Siber G. R., Gorham C., Martin P., Corkery J. C., Schiffman G. Antibody response to pretreatment immunization and post-treatment boosting with bacterial polysaccharide vaccines in patients with Hodgkin's disease. Ann Intern Med. 1986 Apr;104(4):467–475. doi: 10.7326/0003-4819-104-4-467. [DOI] [PubMed] [Google Scholar]
  33. Siber G. R., Weitzman S. A., Aisenberg A. C., Weinstein H. J., Schiffman G. Impaired antibody response to pneumococcal vaccine after treatment for Hodgkin's disease. N Engl J Med. 1978 Aug 31;299(9):442–448. doi: 10.1056/NEJM197808312990903. [DOI] [PubMed] [Google Scholar]
  34. Smit P., Oberholzer D., Hayden-Smith S., Koornhof H. J., Hilleman M. R. Protective efficacy of pneumococcal polysaccharide vaccines. JAMA. 1977 Dec 12;238(24):2613–2616. [PubMed] [Google Scholar]
  35. Weitzman S., Aisenberg A. C. Fulminant sepsis after the successful treatment of Hodgkin's disease. Am J Med. 1977 Jan;62(1):47–50. doi: 10.1016/0002-9343(77)90348-5. [DOI] [PubMed] [Google Scholar]

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