Antibody response to the 23-valent pneumococcal polysaccharide vaccine after conjugate vaccine in patients with chronic lymphocytic leukemia

Figures & data

Table 1. Clinical and laboratory characteristics of the patients with CLL

Character	Patients with CLL (n = 20)
Sex M/F	11/9
Age (years)	63 (47–86)
Binet A/B/C	12/2/6
Past CLL therapy	7 (35%)
Lymphocyte count (x10^9/l)	21.9 (0.9–140.0)
Platelet count (x10^9/l)	141 (38–372)
Hemoglobin (g/l)	135 (81–153)
Neutrophil count (x10^9/l	4.0 (0.6–12.1)
IgG (g/l)	7.4 (3.2–12.5)

The values are expressed as medians and ranges.

Table 2. Pre- and post-vaccination antibody concentrations to seven serotypes included in the 7-valent pneumococcal conjugate vaccine (PCV7, bold) and two serotypes included in the 23-valent pneumococcal polysaccharide vaccine (PPV23) in patients with CLL and in controls

	Pre-vaccination antibody concentration GMC (μg/ml) (quartiles)		Post-vaccination antibody concentration GMC (μg/ml) (quartiles)^a
Serotype	CLL (n = 20)	Control (n = 8)	CLL (n = 20)	Control (n = 8)	p-value^a
4	0.12 (0.02–0.40)	0.34 (0.13–0.90)	0.13 (0.02–0.67)	1.96 (1.36–2.82)	<0.001
5	0.16 (0.08–0.44)	0.15 (0.08–0.25)	0.22 (0.08–0.64)	2.20 (0.53–5.57)	0.002
6B	0.46 (0.11–1.69)	0.30 (0.06–1.24	0.56 (0.14–3.39)	2.28 (0.75–9.96)	0.063
7F	0.38 (0.07–1.27)	0.56 (0.31–1.23)	0.55 (0.07–1.83)	6.74 (2.97–13.8)	<0.001
9V	0.51 (0.23–2.33)	0.91 (0.17–5.06)	0.62 (0.32–2.29)	3.04 (0.58–12.1)	0.033
14	0.77 (0.20–4.14)	1.56 (0.45–5.83)	0.96 (0.17–6.20)	6.65 (3.00–24.0)	0.021
18C	0.93 (0.26–3.06)	1.55 (1.00–2.47)	1.06 (0.27–4.07)	6.81 (3.82–15.7)	0.010
19F	0.97 (0.30–2.88)	0.83 (0.31–1.56)	1.29 (0.33–4.20)	4.18 (1.88–6.05)	0.055
23F	0.53 (0.14–1.56)	0.82 (0.25–2.23	0.67 (0.13–4.41)	2.29 (2.07–3.32)	0.150

^aBetween post-vaccination concentrations in patients with CLL and controls

^aIndependent-samples Mann–Whitney U-test (statistical significance if p ≤ .05)

Table 3. Significant response rates and post-vaccination antibody concentrations suggestive of protection (≥0.35 μg/ml) to seven serotypes included in PCV7 (bold) and two serotypes included in PPV23 in patients with CLL and controls

	Response rate^a			Post-vaccination concentration ≥0.35 μg/ml
	CLL	Controls		CLL	Controls
Serotype	n = 20 (%)	n = 8 (%)	p-value^b	n = 20 (%)	n = 8 (%
4	2 (10)	7 (88)	<0.001	7 (35)	8 (100)
5	4 (20)	8 (100)	<0.001	6 (30)	8 (100)
6B	2 (10)	6 (75)	0.002	10 (50)	7 (88)
7F	3 (15)	6 (75)	<0.001	14 (70)	8 (100)
9V	3 (15)	7 (88)	0.001	13 (65)	8 (100)
14	2 (10)	7 (88)	<0.001	12 (60)	8 (100)
18C	2 (10)	6 (75)	0.002	15 (75)	8 (100)
19F	3 (15)	7 (88)	0.001	15 (75)	8 (100)
23F	2 (10)	4 (50)	0.038	13 (65)	8 (100)

^aDefined as an at least twofold increase and a post-vaccination concentration of at least 0.35 μg/ml

^bFisher´s exact test