Antibody Response to Pretreatment Immunization and Post-treatment Boosting with Bacterial Polysaccharide Vaccines in Patients with Hodgkin's Disease

Siber, George R.; Gorham, Catherine; Martin, Pauline L.; Corkery, Joseph; Schiffman, Gerald

doi:10.7326/0003-4819-104-4-467

Cited by 55 publications

(28 citation statements)

References 45 publications

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“…Further, pneumococcal sepsis may occur with strains not represented in the vaccine: this may account for up to 15% of cases of pneumococcal sepsis. 19 The other major question that requires answering is how often immunisations should be given. The original work in immunocompetent patients has suggested that antibodies to pneumococcal polysaccharides remain increased for at least 10 years, 20 although it appears that splenectomised patients may lose their antibody faster and require reimmunisation after three to five years.…”

Section: Discussionmentioning

confidence: 99%

Northern region asplenia register--analysis of first two years

Spickett

Bullimore

Wallis

et al. 1999

Journal of Clinical Pathology

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Objectives-To assess the feasibility of setting up a register of patients with asplenia within a defined geographical area; to ensure that guidelines on best practice were implemented; to obtain information on antibody levels to pneumococcal capsular polysaccharides and Haemophilus influenzae type b capsular polysaccharide, before and after immunisation and annually thereafter; to raise awareness of risks among clinicians and to oVer advice on management. Design-Prospective recruitment using multiple sources of recruitment. Annual follow up reminders sent from Registration Centre. Subjects-Population of (old, pre-1995) Northern Health Region: approximately 3.1 million. Main outcome measures-Data were obtained on reasons for asplenia, duration of asplenia, use of prophylactic antibiotics, Medic-Alert bracelets, immunisations, antibody levels, death. Results-The register was initiated at the beginning of April 1995 and ran to the end of March 1997. After two years of operation, 1111 cases had been registered but the response from some health districts was poor. Major primary causes of asplenia were trauma (264), other surgical (198), lymphoproliferative disease (154), and idiopathic thrombocytopenic purpura (147). There were 664 patients on prophylactic antibiotics, of whom 498 were on continuous antibiotics. Only 18 had any type of warning bracelet. Antibody measurements were carried out at least once on 75% of patients; 306 patients had satisfactory antibody levels on first blood sample in year 1, rising to 405 in year 2; 43 patients failed to make any antibody response to Pneumovax despite multiple immunisations, and three patients failed to respond to Hib vaccine. Sixteen patients with satisfactory antibody levels in year 1 had low levels in year 2 requiring vaccine boosters. Sixteen deaths were reported, two of which were directly attributable to overwhelming sepsis. Conclusions-Registration has been successful and has raised awareness of the management of asplenia. Compliance with antibiotic prophylaxis and immunisation was initially poor. A potential high risk group of vaccine non-responders has been identified and poor persistence of pneumococcal antibodies has been identified which is likely to alter approaches to immunisation in asplenic patients. (J Clin Pathol 1999;52:424-429)

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Section: Discussionmentioning

confidence: 99%

Northern region asplenia register--analysis of first two years

Spickett

Bullimore

Wallis

et al. 1999

Journal of Clinical Pathology

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“…Multiple studies have shown that a second dose of influenza vaccine can enhance the antibody response in both children and adults receiving chemotherapy who mounted an inadequate immunologic response to the initial dose. [38][39][40][41] Whether the administration of additional or "booster" doses, or increasing the concentration of the antigen contained within the vaccine 42,43 will improve the effectiveness of the vaccine remains to be determined.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of the Influenza Vaccine in Patients with Malignant Lymphoma

Mazza¹,

Yale²,

Arrowood³

et al. 2005

Clinical Medicine & Research

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“…Because of the risk of apSI, vaccination against pneumococci is advised in the r\etherlands (1cl). By preference the vaccination is given befare splenectomy because of a higher level of antibodies that is reached (17). For patients suffering from Hodgkin's disease the efficiency is thought to be higher if the vaccination is given before the start of chemotherapy (16).…”

Section: Responsementioning

confidence: 99%

Results of Splenectomy Performed on a Group of 91 Children

Meekes¹,

Staak

Oostrom

1995

Eur J Pediatr Surg

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SummaryIn the period 1971-1990 91 children underwent splenectomies in the University Hospital of Nijmegen, The most important indications are hereditary spherocytosis, Hodgkin's disease and very severe immune thrombocytopenic purpura (ITP). Splenec tomy after a traumatic rupture of the spleen has become less frequent: from 2 0 % in 1971-1980 to 4% in 1981-1990. Short-term complica tions included thrombocytosis (84%), fever without an obvious cause (46 %), which is quite regularly seen in patients suffering from Hodg kin's disease (48 %), and infections of the respiratory tract in 10 % of the patients. The platelet count shows a steady increase in the first nine post-operative days. No tliromboembolic complications were seen. Based upon the literature there seems to be no reason at this moment for anti-platelet aggregation therapy when platelet counts arc below 1000xl09/l. More information about long-term complications was obtained through a questionnaire completed by general practitioners. The morbidity through overwhelming post splenectomy infection (OPSI) is 3.8 % (3/79), the mortality of OPSi is 2.5 % (2/79). Under lying diseases, especially those which involve the immunological system as auto immune haemolytic anemia (AIHA), seem to play an important role in the possible development of OPSI (morbidity 2/11, 18 %). Key words Splenectomy, indications, complications -OPSI Thrombocytosis RésuméUne splénectomie a été pratiquée chez 91 enfants entre [1971][1972][1973][1974][1975][1976][1977][1978][1979][1980][1981][1982][1983][1984][1985][1986][1987][1988][1989][1990]. Les diagnostics les plus fréquents ont été la sphérocytose, la maladie de Hodgkin et le purpura thrombocytopénique. Pendant le même temps, le pourcentage de splénectomie traumatique est descendu de 20% entre 1971-1980, à 4% dans la période 1981-1990. Les complications précoces ont comporté: une augmentation des Üirombocytes (84%), de la température sans cause précise (46 %) et une infection des voies respiratoires supérieures chez 10% des patients. Une température de cause imprécise fut observée particulièrement fréquemment chez les patients attaints de maladie de Hodgkin. Le nombre des thrombocytes est élevé dans les premiers neuf jours post-opératoires; il n'y a toutefois eu aucune complication thrombo-embolique. De ce fait, il apparaît qu'il n'est pas nécessaire d'envisager de traitement thrombocytopénique lorsque le compte des thrombocytes est en dessous de lOOOxlü'Vl. Evidemment les complications à loirUmne échéiince restent une question pendante. Dans le relevé, on constate une fréquence de sepsis post-splénectomie de 3,8 % (3/79) et une mortalité de 2,5 % (2/79), En conséquence, les maladies de base qui intéressent le système immunologique comme ranémie auto-immunohémolytique jouent un rôle important au regard d'une possible OPSI (morbicüté 2/11, 18%). Hinsichtlich Langzeitkomplikationen wurde ein Fragebogen verschickt. Bei der Auswertung ergab sich eine Postsplenektomie-Sepsis-Häufigkeit von 3,8 % (3/79) und eine Mortalität von 2,5 % (2/79)...

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Antibody Response to Pretreatment Immunization and Post-treatment Boosting with Bacterial Polysaccharide Vaccines in Patients with Hodgkin's Disease

Cited by 55 publications

References 45 publications

Northern region asplenia register--analysis of first two years

Northern region asplenia register--analysis of first two years

Efficacy of the Influenza Vaccine in Patients with Malignant Lymphoma

Results of Splenectomy Performed on a Group of 91 Children

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