Siber G R, Weitzman S A, Aisenberg A C
Rev Infect Dis. 1981 Mar-Apr;3 Suppl:S144-59. doi: 10.1093/clinids/3.supplement_1.s144.
We examined the antibody response of patients with Hodgkin's disease to a variety of vaccines to formulate guidelines for immunization. During and after treatment for Hodgkin's disease, both pre- and postimmunization levels of antibody to Streptococcus pneumoniae, Hemophilus influenzae type b, and tetanus toxoid antigens were significantly lower in patients than in controls. Impairments in the antibody response were most severe in intensively treated patients and improved as the interval between treatment and immunization increased. The primary, but not the secondary, antibody responses to the hemagglutinins of the influenza virus A/Victoria/75 and A/New Jersey/76 also were impaired in treated patients. Before treatment antibody responses to pneumococcal vaccine was normal regardless of the stage of disease unless treatment began within 10 days of immunization. Levels of antibody decreased during therapy in proportion to the intensity of treatment but remained higher than levels in comparably treated patients who were not immunized at diagnosis. We recommend that patients with Hodgkin's disease receive pneumococcal vaccine at diagnosis at least 10 days before initiation of treatment. Patients who are treated before immunization may be immunized several months after treatment, although the response of heavily treated individuals to vaccination may be marginal. More studies are needed to determine whether reimmunization of patients initially immunize at diagnosis is safe and effective.
我们检测了霍奇金病患者对多种疫苗的抗体反应，以制定免疫指南。在霍奇金病治疗期间及之后，患者针对肺炎链球菌、b型流感嗜血杆菌和破伤风类毒素抗原的免疫前及免疫后抗体水平均显著低于对照组。抗体反应受损在强化治疗的患者中最为严重，并随着治疗与免疫之间间隔时间的增加而改善。治疗患者对甲型流感病毒A/维多利亚/75和A/新泽西/76血凝素的初次抗体反应（而非二次抗体反应）也受损。治疗前，无论疾病处于何阶段，对肺炎球菌疫苗的抗体反应均正常，除非在免疫后10天内开始治疗。治疗期间抗体水平随治疗强度成比例下降，但仍高于诊断时未免疫的类似治疗患者的水平。我们建议霍奇金病患者在诊断时，至少在开始治疗前10天接种肺炎球菌疫苗。在免疫前接受治疗的患者可在治疗后数月进行免疫，尽管强化治疗患者对疫苗接种的反应可能有限。需要更多研究来确定对诊断时初次免疫的患者进行再次免疫是否安全有效。
