A longitudinal study of class and subclass antibody response to pneumococcal vaccination in splenectomized individuals with special reference to patients with Hodgkin's disease.
Antibody class and subclass response to pneumococcal vaccination was monitored in 173 splenectomized individuals. The distribution according to indication for splenectomy was Hodgkin's disease (HD; n = 41), non-Hodgkin lymphoma (NHL; n = 25), autoimmune hemolytic anemia or idiopathic thrombocytopenic purpura (n = 17), accidental splenectomy during abdominal surgery for malignant (AMA; n = 15) and benign (ABE; n = 42) disease and splenectomy due to splenic rupture caused by trauma (TRAUMA; n = 33). Pre-vaccination total IgG pneumococcal antibody values (i.e. against the whole antigen = the vaccine) in the NHL patients were lower than in the ABE and TRAUMA groups (p less than 0.05). The response to vaccination in HD and NHL patients did not differ from that in the other patient groups. Furthermore, pre-vaccination values did not differ between HD patients vaccinated before splenectomy and treatment and those vaccinated after, although the former group showed a better response to vaccination (p less than 0.05). HD and TRAUMA patients were followed by serial serum sampling. The antibody values declined to pre-treatment levels after 3 years but no differences either between HD and TRAUMA patients or between HD patients vaccinated before or after splenectomy and treatment were observed with regard to antibody decrease. It is concluded that pneumococcal antibody levels increased in all splenectomized patient groups following vaccination. The pattern of the antibody decline motivates revaccination studies in patients 2 yr post-immunization.
Grimfors
G
G
Department of Medicine, Karolinska Hospital, Stockholm, Sweden.
Söderqvist
M
M
Holm
G
G
Lefvert
A K
AK
Björkholm
M
M
D000328:Adult; D000743:Anemia, Hemolytic / Q000276:immunology* / Q000601:surgery; D000917:Antibody Formation; D001428:Bacterial Vaccines / Q000008:administration & dosage*; D006689:Hodgkin Disease / Q000276:immunology* / Q000601:surgery; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D008137:Longitudinal Studies; D008228:Lymphoma, Non-Hodgkin / Q000276:immunology* / Q000601:surgery; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines; D011696:Purpura, Thrombocytopenic / Q000276:immunology* / Q000601:surgery; D012421:Rupture; D013154:Spleen / Q000293:injuries; D013156:Splenectomy; D013296:Streptococcus pneumoniae
D001428:Bacterial Vaccines; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D022242:Pneumococcal Vaccines