Donaldson S S, Vosti K L, Berberich F R, Cox R S, Kaplan H S, Schiffman G
Rev Infect Dis. 1981 Mar-Apr;3 Suppl:S133-43. doi: 10.1093/clinids/3.supplement_1.s133.
Nineteen children with Hodgkin's disease were immuized with dodecavalent pneumococcal vaccine; the efficacy of vaccination, the duration of response, and the significance of the time of immunization in relation to splenectomy and subsequent irradiation and chemotherapy were investigated. Eight children were immunized before splenectomy, and 11 were immunized after splenectomy, irradiation, and chemotherapy. All children were irradiated, and all but two received chemotherapy with MOPP (nitrogen mustard, vincristine sulfate, procarbazine, and prednisone). Sera were assayed for antibodies to the 12 polysaccharide types in the vaccine. The group of children immunized before splenectomy had a significant antibody response to 67% of the antigens tested, whereas the group immunized after splenectomy responded to 40% of the antigens (P less than 0.0001). The duration of response was variable. Pneumococcal vaccine was more likely to provoke an immunologic response if administered before splenectomy than if administered after splenectomy, irradiation, and chemotherapy; however, the response was not uniform. A response to one antigen did not necessarily imply a response to other antigens. In the absence of a readily available assay to determine a protective antibody response, one cannot rely on the vaccine as the sole means of preventing pneumococcal infections in asplenic children with Hodgkin's disease.
19名霍奇金病患儿接种了12价肺炎球菌疫苗；对疫苗接种的效果、反应持续时间以及免疫时间与脾切除术、随后的放疗和化疗之间的关系进行了研究。8名儿童在脾切除术前接种疫苗，11名在脾切除、放疗和化疗后接种。所有儿童均接受了放疗，除2名儿童外，其余均接受了MOPP（氮芥、硫酸长春新碱、丙卡巴肼和泼尼松）化疗。检测血清中针对疫苗中12种多糖类型的抗体。脾切除术前接种疫苗的儿童组对67%的检测抗原产生了显著的抗体反应，而脾切除术后接种疫苗的儿童组对40%的抗原产生了反应（P小于0.0001）。反应持续时间各不相同。与脾切除、放疗和化疗后接种相比，脾切除术前接种肺炎球菌疫苗更有可能引发免疫反应；然而，反应并不一致。对一种抗原的反应不一定意味着对其他抗原也有反应。在缺乏一种易于获得的检测方法来确定保护性抗体反应的情况下，不能将疫苗作为预防霍奇金病脾切除患儿肺炎球菌感染的唯一手段。
