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Previous Volume 297:245-248 August 4, 1977 Number 5 Next

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Abstract

To define the contribution of aggressive lymphoma treatment to the risk of post-splenectomy septicemia, we investigated the humoral immunity of 44 patients with Hodgkin's disease. Specific antibody against Haemophilus influenzae Type b was significantly reduced (mean, 147 ng per milliliter, P less than 0.01) in patients receiving combined treatment (radiotherapy and chemotherapy), whereas single treatment reduced titers marginally (chemotherapy) or not at all (radiotherapy). Untreated patients had normal values (396 ng per milliliter), and splenectomy was without effect. In some patients who received combined treatment, titers were reduced to levels seen in infants. IgM levels were likewise normal in untreated patients. Chemotherapy, however, significantly reduced IgM levels (P less than 0.025), an effect potentiated by prior splenectomy. IgG, IgA, alternate-pathway activity, C3, C4 and CH50 were all normal or elevated. Aggressive treatment with chemotherapy and radiation impairs humoral defense against encapsulated micro-organisms, and thus magnifies the risk of post-splenectomy septicemia in patients with Hodgkin's disease.

This article has been cited by other articles:

• Jakacki, R., Luery, N., McVerry, P., Lange, B. (1990). Haemophilus influenzae Diphtheria Protein Conjugate Immunization after Therapy in Splenectomized Patients with Hodgkin Disease. ANN INTERN MED 112: 143-144 [Abstract]  
• SIBER, G. R., GORHAM, C., MARTIN, P., CORKERY, J. C., SCHIFFMAN, G. (1986). Antibody Response to Pretreatment Immunization and Post-treatment Boosting with Bacterial Polysaccharide Vaccines in Patients with Hodgkin's Disease. ANN INTERN MED 104: 467-475 [Abstract]  
• Takaue, Y., Sullivan, M. P., Ramirez, I., Cleary, K. R., van Eys, J. (1986). Second Malignant Neoplasm in Treated Hodgkin's Disease: Report of a Patient and Scope of the Problem. Arch Pediatr Adolesc Med 140: 49-51 [Abstract]  
• Armitage, J. O., Dick, F. R., Goeken, J. A., Foucar, M. K., Gingrich, R. D. (1983). Second Lymphoid Malignant Neoplasms Occurring in Patients Treated for Hodgkin's Disease. Arch Intern Med 143: 445-450 [Abstract]  
• SCHWARTZ, J. S. (1982). Pneumococcal Vaccine: Clinical Efficacy and Effectiveness. ANN INTERN MED 96: 208-220 [Abstract]  
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• MINOR, D. R., SCHIFFMAN, G., McINTOSH, L. S. (1979). Response of Patients with Hodgkin's Disease to Pneumococcal Vaccine. ANN INTERN MED 90: 887-892 [Abstract]