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Use and efficacy of pneumococcal vaccine in patients with Hodgkin disease
Abstract:
Fulminant bacterial sepsis has been described in patients with Hodgkin disease who have undergone splenectomy for staging purposes. The organisms commonly associated with sepsis in this setting include Streptococcus pneumoniae and Haemophilus influenzae. Polyvalent pneumococcal vaccine (Merck) has recently been licensed and has been suggested for use in patients with Hodgkin disease who are at risk for postsplenectomy sepsis. We administered 14-valent pneumococcal vaccine to 24 patients with Hodgkin disease and 24 normal controls, and measured antibody response to 13 antigens at time of immunization and at 3 wk and 3 mo following immunization. Our results indicate that patients who have been previously treated for Hodgkin disease, with chemotherapy, radiotherapy, or both, have severe impairment of antibody response. Untreated patients, however, respond in a manner similar to normal controls.
Insights
Patients with Hodgkin disease treated with chemotherapy or radiotherapy show impaired antibody response to pneumococcal vaccine. Untreated patients, however, respond normally, suggesting treatment impacts immune function.
Area of Science:
- Immunology
- Oncology
- Vaccinology
Background:
- Fulminant bacterial sepsis is a risk for patients with Hodgkin disease post-splenectomy.
- Streptococcus pneumoniae and Haemophilus influenzae are common sepsis pathogens in this population.
- Polyvalent pneumococcal vaccine is recommended for at-risk Hodgkin disease patients.
Purpose of the Study:
- To evaluate the antibody response to pneumococcal vaccine in patients with Hodgkin disease.
- To compare vaccine response in treated versus untreated Hodgkin disease patients and normal controls.
Main Methods:
- Administered 14-valent pneumococcal vaccine to 24 Hodgkin disease patients and 24 controls.
- Measured antibody response to 13 antigens at immunization, 3 weeks, and 3 months post-immunization.
Main Results:
- Previously treated Hodgkin disease patients (chemotherapy, radiotherapy, or both) exhibited severely impaired antibody responses.
- Untreated Hodgkin disease patients demonstrated antibody responses comparable to normal controls.
Conclusions:
- Chemotherapy and radiotherapy significantly impair antibody response to pneumococcal vaccine in Hodgkin disease patients.
- Vaccination may be less effective in previously treated Hodgkin disease patients.
- Further research is needed to optimize vaccination strategies for immunocompromised cancer patients.