Antibody Responses to Polysaccharide and Polysaccharide-Conjugate Vaccines after Treatment of Hodgkin Disease

. Objective : To compare the immunogenicity of polysaccharide-conjugate vaccines with that of polysaccharide vaccines in patients previously treated for Hodgkin disease. . Design : All patients were immunized with Haemophilus influenzae type b (HIB)-conjugate and 4-valent meningococcal polysaccharide vaccines. Subgroups of patients were randomly assigned to receive either 23-valent pneumococcal polysaccharide vaccine or a 7-valent pneumococcal-conjugate vaccine that links seven pneumococcal serotypes to the outer membrane protein complex of Neisseria meningitidis. . Patients : 144 patients who had completed treatment for Hodgkin disease, which had been diagnosed at least 2 years before the study. . Measurements : Antigen-specific antibody concentrations before and 3 to 6 weeks after immunization ; number of persons who achieved anti-HIB antibody concentrations considered to be in the protective range. . Results : The geometric mean anti-HIB antibody concentration increased from 1.79 μg/mL before immunization to 54.1 μg/mL after ; the percentage of persons with antibody concentrations in the protective range increased from 62% before immunization to 99% after. Patients immunized with 23-valent pneumococcal vaccine had a geometric mean pneumococcal antibody concentration after immunization (9.15 μg/mL) that was similar to that of healthy controls (10.0 μg/mL) for the seven serotypes measured. In contrast, patients who received 7-valent pneumococcal-conjugate vaccine had a significantly lower mean response compared with patients who received 23-valent vaccine ; their geometric mean antibody concentration after immunization was 4.95 μg/mL (P = 0.005). . Conclusion : A single dose of HIB-conjugate vaccine was immunogenic in patients who had completed treatment for Hodgkin disease diagnosed at least 2 years before immunization. In addition, responses to the 23-valent pneumococcal and 4-valent meningococcal vaccines were equivalent to those seen in healthy controls. Finally, patients had a significantly lower response to a single dose of 7-valent pneumococcal-conjugate vaccine than to 23-valent vaccine.