Infectious complications in hematological malignancy (HM) patients are the major cause of morbi-mortality. Antibody (Ab) response to protein and polysaccharide immunizations at early stages may have an important value for predicting patients prone to infections.
To asses specific antibody response to polysaccharide and protein vaccine and the potential role of Typhim Vi in HM.
Observational study of the specific Ab response to polysaccharide and protein vaccine in a group of patients with recurrent infections and HM. All patients were immunized with PPV (Pneumo23), Salmonella Typhi (Typhim Vi) and Tetanus Toxoid (Diftavax) of Sanofi Pasteur MSD. Blood was drawn after 4 weeks post vaccination. Specific Ab concentrations in response to PPV,Typhim Vi and Diftavax were measured by ELISA (Binding Site, UK), defining 3-fold increase as normal response.
Twenty-eight patients were studied (mean age 63Ã‚Â±13; 21 women).
All patients underwent clinical and immunological examination and were classified as either: Ã‚Â Advanced stages (CLL n = 5, HL n= 1, NHL n=13) and early stages (MGUS; n=9). Twenty-one (75%) and 15 (53%) patients had protective anti-PCP and anti-TT baseline levels, respectively (12 presented both); while onlyÃ‚Â 2 (7%) had anti-Typhim baseline antibodies. Nine patients (32%) responded to Typhim, 5 on the MGUS group, with one patients responding to all three vaccines. High discrepancy was observed in the three responses, suggesting the role of primary and secondary responses.
Anti-Typhim responses may add value to the immunological assessment of HM patients, in whom primary responses might better predict susceptibility to recurrent bacterial infections.