Response of Patients with Hodgkin's Disease to Pneumococcal Vaccine

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Abstract
Post-splenectomy, 41 patients previously treated for Hodgkin''s disease were given pneumococcal vaccine and type-specific antibody [Ab] levels were measured before and after immunization. Post-immunization Ab levels in patients with Hodgkin''s disease were significantly lower than those in normal control subjects for 10 of the 12 serotypes measured. The mean post-immunization Ab level for patients (587 .+-. 427 ng of Ab N/ml) was much lower than that for control subjects (1787 .+-. 694). Ab levels tended to increase with time from therapy for Hodgkin''s disease and several patients who did not receive therapy for more than 3 yr had normal responses to immunization. Despite vaccination, 1 patient developed pneumococcal meningitis and another developed pneumococcal bacteremia. Both infected patients had low post-immunization mean Ab levels (282 and 137 ng/ml, respectively). Post-splenectomy sepsis in patients with Hodgkin''s disease is related to a humoral immune deficiency probably induced by radiation and chemotherapy which persists for several years.