human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: As a consequence of the significantly larger inoculum of lymphoid cells present in peripheral blood stem cell ( PBSC ) harvests compared to bone marrow ( BM ) , it is possible that autoPBSCT recipients may have an earlier and * or enhanced response to vaccines . Until data to confirm this become available , the European Blood and Marrow Transplantation Association ( EBMT ) recommend that all transplant recipients be immunized in the same way regardless of stem cell source . We performed a prospect i ve study comparing serological responses to influenza , pneumococcal polysaccharide and tetanus toxoid vaccines between autoPBSCT with autoBMT recipients .  Antibody responses in sibling HLA-matched allogeneic BMT ( alloBMT ) survivors were also evaluated . All vaccines were administered within the first 2 years after stem cell transplantation . Fifty patients were enrolled . The time of vaccination after transplant was similar between autoPBSCT ( mean 11 months for each vaccine ) and autoBMT recipients ( mean 12 months except 13 months for tetanus toxoid ) ( P = NS ) . Serological responses were poor and no significant difference in response to any of the vaccines used was seen between the three transplant cohorts . We provide no evidence that current EBMT guidelines be modified . Large prospect i ve vaccine studies are needed to address the issue more fully . Bone Marrow Transplantation ( 2001 ) 28 , 775–781 Abstract In order to evaluate the impact of influenza-like illness and the effectiveness of influenza vaccination  in children with oncohematological disease who have completed cancer therapy , 182 children with a diagnosis of oncohematological disease were divided into two subgroups on the basis of the length of time off therapy ( < 6 months or 6–24 months ) and r and omised 1:1 to receive influenza vaccination or not . The controls were 91 otherwise healthy children unvaccinated against influenza .  The results show that the clinical and socioeconomic impact of influenza-like illnesses and the effectiveness of influenza vaccination  in oncohematological children who have completed cancer therapy are related to the length of the off therapy period , and seem to be significantly greater in those who have been off therapy for less than 6 months in comparison with healthy controls . This suggests that the administration of influenza vaccination should be strongly recommended only among oncohematological children who have been off therapy for less than 6 months Although vaccination against Streptococcus pneumoniae ( S. pneumoniae ) and Haemophilus influenzae type b ( Hib ) is recommended for immunocompromised patients , such as patients with B-cell chronic lymphocytic leukaemia ( B-CLL ) , its protective effect is question able . We studied antibody responses to pneumococcal polysaccharide vaccine ( Pneumovax-23 ) and to conjugated H. influenzae type b-vaccine ( Act-Hib ) in 25 patients with B-CLL . After vaccination , the number of patients with antibody levels in the protective range against pneumococcal serotypes and H. influenzae b increased from 9 ( 38 % ) to 12 ( 50 % ) of 24 patients and from 8 ( 35 % ) to 11 ( 48 % ) of 23 patients , respectively . The patients with adequate antibody response to Pneumovax-23 and Act-Hib had significantly less advanced stages of B-CLL , higher gammaglobulin levels , total IgG-levels and IgG-subclasses 2 and 4 levels , and lower levels of soluble CD23 . Consequently , vaccination with these vaccines should be given as soon as the diagnosis of B-CLL is made , early in the course of the disease with determination of post-vaccination antibody levels An open , r and omised study was performed to determine whether two doses of influenza vaccine were more effective than one to elicit an immune response in 70 patients with haematological malignancies . The responses were not improved by two doses compared with one ( influenza A virus serotypes H1/N1 18 % vs. 22 % and H3/N2 26 % vs. 14 % ; influenza B 25 % vs. 22 % ) . The results were similar in patients with ongoing and discontinued therapy . Patients treated with monoclonal antibodies for lymphoma had very poor responses . We conclude that two doses of influenza vaccine do not improve the antibody response in patients with haematological malignancies This study assessed the safety and immunogenicity of a pediatric formulation of the 2003–2004 inactivated , trivalent , split virion influenza vaccine , administered in a 2-dose schedule in healthy children ages 6–36 months , of whom 94 % had protective titers ( ≥1/40 ) to at least 1 antigen . The 2003–2004 split virion influenza vaccine was safe and immunogenic in young children BACKGROUND There is a decrease in antibody levels after hematopoietic stem cell transplant ( HSCT ) , and such patients may be at increased risk of acquiring vaccine-preventable infection . A simple and vali date d revaccination schedule is required . The aim of this study was to evaluate the immunogenicity of a revaccination schedule for pediatric HSCT recipients . METHODS Thirty-eight children ( age , 1 - 18 years ) who had undergone autologous or allogeneic HSCT for malignant diseases were recruited . All children received vaccinations in accordance with a predefined schedule . Antibody concentrations were measured before and 2 - 4 weeks after vaccination against tetanus ; Haemophilus influenzae type b ( Hib ) ; meningococcus C ; measles ; poliovirus serotypes 1 , 2 , and 3 ; and 9 pneumococcus serotypes . RESULTS Before vaccination , protective antibody levels were found for tetanus in 95 % of patients ( geometric mean concentration [ GMC ] , 0.07 IU/mL ; 95 % CI , 0.05 - 0.1 IU/mL ) , for Hib in 63 % ( GMC , 0.34 microg/mL ; 95 % CI , 0.21 - 0.57 microg/mL ) , for measles in 60 % ( GMC , 102 mIU/mL ; 95 % CI , 41 - 253 mIU/mL ) , for meningococcus C in 11 % ( geometric mean titer [ GMT ] , 1:4 ; 95 % CI , 1:2 - 1:8.4 ) , for all 3 poliovirus serotypes in 29 % , and for all 9 pneumococcal serotypes in 0 % . Vaccination result ed in a significant increase ( P < or = .05 ) in antibody levels to each vaccine antigen studied , with 100 % of patients achieving protection against tetanus ( GMC , 2.2 IU/mL ; 95 % CI , 1.8 - 2.7 IU/mL ) , 100 % achieving protection against Hib ( GMC , 8.4 microg/mL ; 95 % CI , 7.6 - 9.3 microg/mL ) , 100 % achieving protection against measles ( GMC , 2435 mIU/mL ; 95 % CI , 1724 - 3439 mIU/mL ) , 100 % achieving protection against meningococcus C ( GMT , 1:5706 ; 95 % CI , 1:3510 - 1:9272 ) , 92 % achieving protection against the 3 poliovirus serotypes , and > or = 80 % achieving protection against each of the heptavalent pneumococcal conjugate vaccine-associated serotypes . No factors relevant to age , underlying disease , or treatment type were found to significantly influence responses . CONCLUSION Revaccination of pediatric HSCT recipients in accordance with this revaccination schedule provides a high level of protection against these vaccine-preventable diseases Young children and allogeneic hematopoietic cell transplantation ( HCT ) recipients respond poorly to polysaccharide antigens , rendering them susceptible to severe infections because of encapsulated bacteria . This study evaluated the responses of 127 HCT patients , median age 23.0 years , vaccinated with PNCRM7 and Haemophilus influenzae ( HIB ) conjugate , 2 conjugate vaccines highly immunogenic in healthy children .  Median time to vaccination was 1.1 years after HCT . Sixty-two percent of patients responded to PNCRM7 ( 45 of 51 children , 34 of 76 adults , P < .001 ) . Overall response to HIB was 86 % , including 77 % of PNCRM7 nonresponders . Although PNCRM7 response was adversely affected by older age ( P < .001 ) , individuals > or = 50 years old responded significantly better if vaccinated following acquisition of specific minimal milestones of immune competence , CD4 > 200/microL , IgG > 500 mg/dL , PHA within 60 % lower limit of normal ( 11 of 19 versus 0 of 8 , P < .006 ) . A similar trend was observed in patients with limited chronic graft-versus-host disease ( cGVHD ) .  In all patients , higher levels of circulating CD4(+)CD45RA cells correlated with improved PNCRM7 response . These data demonstrate that PNCRM7 is immunogenic in allogeneic HCT patients , including older adults , but suggest that vaccination at fixed intervals after HCT , irrespective of immune competence , may limit its effectiveness . Prospect i ve , multicenter trials assessing the best strategy to administer this vaccine and its impact on pneumococcal infections following transplantation are warranted Patients undergoing autologous hematopoietic stem cell transplantation ( autoHCT ) are at increased risk for infection with Streptococcus pneumoniae and have impaired antibody responses to pneumococcal polysaccharide vaccines . We performed this study to examine the ability of autoHCT patients to respond to a heptavalent pneumococcal conjugate vaccine ( PCV7 ) given after transplantation and to determine whether there was a potential benefit of immunizing these patients before stem cell collection . Sixty-one patients scheduled for autoHCT were r and omized to receive either PCV7 or no vaccine before stem cell collection . After stem cell reinfusion , all study patients were immunized with PCV7 at 3 , 6 , and 12 months . Pneumococcal immunoglobulin G antibody concentrations were measured at the time of each immunization and 1 month after the 12-month dose . Serotype-specific pneumococcal antibody concentrations were significantly higher in patients immunized with PCV7 before stem cell collection compared with patients not immunized before their stem cells were collected for 6 of 7 serotypes at 3 months , 6 of 7 serotypes at 6 months , 4 of 7 serotypes at 12 months , and 3 of 7 serotypes at 13 months . After the 3-dose series of PCV7 after autoHCT , > 60 % of study patients had protective concentrations of antibody to all 7 vaccine serotypes regardless of immunization before stem cell collection . Pneumococcal conjugate vaccine is immunogenic in autoHCT patients and may be an effective strategy to prevent invasive disease after transplantation In 27 patients r and omized to receive commercial trivalent influenza vaccine ( TIV ) containing 15 microg of the hemagglutinin ( HA ) of influenza A ( H3N2 and H1N1 ) and B virus or a recombinant vaccine ( rHAO ) containing 15 , 45 , or 135 microg of each HA , reactogenicity was minor . Among patients with similar prevaccination titers , 40 % given 45 microg and 60 % given 135 microg of rHAO developed an increase in influenza A/H3 neutralizing antibody levels ; there were no increases in 4 given TIV . For each vaccine , the highest frequencies of increases in neutralizing antibody levels and the highest mean titers occurred in those given the 135- microg vaccine The serum antibody responses of splenectomized patients with non-Hodgkin 's lymphoma ( NHL ) who had been immunized with a polyvalent pneumococcal vaccine ( Pneumovax 23 )  were evaluated by an enzyme-linked immunosorbent assay with the 23-valent pneumococcal vaccine as the antigen . A response to immunization , defined as a twofold-or-higher rise of the prevaccination titer of antibodies against Streptococcus pneumoniae polysaccharide , was elicited in 5 of 11 patients with NHL . No significant difference in the level of antibodies against S. pneumoniae polysaccharide between lymphoma patients and patients who had undergone splenectomy for other reasons was detected ( P = 0.83 and 0.87 before and after vaccination , respectively ) . NHL patients who did not respond to the first immunization received a booster dose of the polysaccharide vaccine . This injection did not increase the pneumococcal-antibody titer significantly ( P = 0.7 ) . We conclude that vaccination with pneumococcal polysaccharides in splenectomized patients with 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: As a consequence of the significantly larger inoculum of lymphoid cells present in peripheral blood stem cell ( PBSC ) harvests compared to bone marrow ( BM ) , it is possible that autoPBSCT recipients may have an earlier and * or enhanced response to vaccines . Until data to confirm this become available , the European Blood and Marrow Transplantation Association ( EBMT ) recommend that all transplant recipients be immunized in the same way regardless of stem cell source . We performed a prospect i ve study comparing serological responses to influenza , pneumococcal polysaccharide and tetanus toxoid vaccines between autoPBSCT with autoBMT recipients .  Antibody responses in sibling HLA-matched allogeneic BMT ( alloBMT ) survivors were also evaluated . All vaccines were administered within the first 2 years after stem cell transplantation . Fifty patients were enrolled . The time of vaccination after transplant was similar between autoPBSCT ( mean 11 months for each vaccine ) and autoBMT recipients ( mean 12 months except 13 months for tetanus toxoid ) ( P = NS ) . Serological responses were poor and no significant difference in response to any of the vaccines used was seen between the three transplant cohorts . We provide no evidence that current EBMT guidelines be modified . Large prospect i ve vaccine studies are needed to address the issue more fully . Bone Marrow Transplantation ( 2001 ) 28 , 775–781 Abstract In order to evaluate the impact of influenza-like illness and the effectiveness of influenza vaccination  in children with oncohematological disease who have completed cancer therapy , 182 children with a diagnosis of oncohematological disease were divided into two subgroups on the basis of the length of time off therapy ( < 6 months or 6–24 months ) and r and omised 1:1 to receive influenza vaccination or not . The controls were 91 otherwise healthy children unvaccinated against influenza .  The results show that the clinical and socioeconomic impact of influenza-like illnesses and the effectiveness of influenza vaccination  in oncohematological children who have completed cancer therapy are related to the length of the off therapy period , and seem to be significantly greater in those who have been off therapy for less than 6 months in comparison with healthy controls . This suggests that the administration of influenza vaccination should be strongly recommended only among oncohematological children who have been off therapy for less than 6 months Although vaccination against Streptococcus pneumoniae ( S. pneumoniae ) and Haemophilus influenzae type b ( Hib ) is recommended for immunocompromised patients , such as patients with B-cell chronic lymphocytic leukaemia ( B-CLL ) , its protective effect is question able . We studied antibody responses to pneumococcal polysaccharide vaccine ( Pneumovax-23 ) and to conjugated H. influenzae type b-vaccine ( Act-Hib ) in 25 patients with B-CLL . After vaccination , the number of patients with antibody levels in the protective range against pneumococcal serotypes and H. influenzae b increased from 9 ( 38 % ) to 12 ( 50 % ) of 24 patients and from 8 ( 35 % ) to 11 ( 48 % ) of 23 patients , respectively . The patients with adequate antibody response to Pneumovax-23 and Act-Hib had significantly less advanced stages of B-CLL , higher gammaglobulin levels , total IgG-levels and IgG-subclasses 2 and 4 levels , and lower levels of soluble CD23 . Consequently , vaccination with these vaccines should be given as soon as the diagnosis of B-CLL is made , early in the course of the disease with determination of post-vaccination antibody levels An open , r and omised study was performed to determine whether two doses of influenza vaccine were more effective than one to elicit an immune response in 70 patients with haematological malignancies . The responses were not improved by two doses compared with one ( influenza A virus serotypes H1/N1 18 % vs. 22 % and H3/N2 26 % vs. 14 % ; influenza B 25 % vs. 22 % ) . The results were similar in patients with ongoing and discontinued therapy . Patients treated with monoclonal antibodies for lymphoma had very poor responses . We conclude that two doses of influenza vaccine do not improve the antibody response in patients with haematological malignancies This study assessed the safety and immunogenicity of a pediatric formulation of the 2003–2004 inactivated , trivalent , split virion influenza vaccine , administered in a 2-dose schedule in healthy children ages 6–36 months , of whom 94 % had protective titers ( ≥1/40 ) to at least 1 antigen . The 2003–2004 split virion influenza vaccine was safe and immunogenic in young children BACKGROUND There is a decrease in antibody levels after hematopoietic stem cell transplant ( HSCT ) , and such patients may be at increased risk of acquiring vaccine-preventable infection . A simple and vali date d revaccination schedule is required . The aim of this study was to evaluate the immunogenicity of a revaccination schedule for pediatric HSCT recipients . METHODS Thirty-eight children ( age , 1 - 18 years ) who had undergone autologous or allogeneic HSCT for malignant diseases were recruited . All children received vaccinations in accordance with a predefined schedule . Antibody concentrations were measured before and 2 - 4 weeks after vaccination against tetanus ; Haemophilus influenzae type b ( Hib ) ; meningococcus C ; measles ; poliovirus serotypes 1 , 2 , and 3 ; and 9 pneumococcus serotypes . RESULTS Before vaccination , protective antibody levels were found for tetanus in 95 % of patients ( geometric mean concentration [ GMC ] , 0.07 IU/mL ; 95 % CI , 0.05 - 0.1 IU/mL ) , for Hib in 63 % ( GMC , 0.34 microg/mL ; 95 % CI , 0.21 - 0.57 microg/mL ) , for measles in 60 % ( GMC , 102 mIU/mL ; 95 % CI , 41 - 253 mIU/mL ) , for meningococcus C in 11 % ( geometric mean titer [ GMT ] , 1:4 ; 95 % CI , 1:2 - 1:8.4 ) , for all 3 poliovirus serotypes in 29 % , and for all 9 pneumococcal serotypes in 0 % . Vaccination result ed in a significant increase ( P < or = .05 ) in antibody levels to each vaccine antigen studied , with 100 % of patients achieving protection against tetanus ( GMC , 2.2 IU/mL ; 95 % CI , 1.8 - 2.7 IU/mL ) , 100 % achieving protection against Hib ( GMC , 8.4 microg/mL ; 95 % CI , 7.6 - 9.3 microg/mL ) , 100 % achieving protection against measles ( GMC , 2435 mIU/mL ; 95 % CI , 1724 - 3439 mIU/mL ) , 100 % achieving protection against meningococcus C ( GMT , 1:5706 ; 95 % CI , 1:3510 - 1:9272 ) , 92 % achieving protection against the 3 poliovirus serotypes , and > or = 80 % achieving protection against each of the heptavalent pneumococcal conjugate vaccine-associated serotypes . No factors relevant to age , underlying disease , or treatment type were found to significantly influence responses . CONCLUSION Revaccination of pediatric HSCT recipients in accordance with this revaccination schedule provides a high level of protection against these vaccine-preventable diseases Young children and allogeneic hematopoietic cell transplantation ( HCT ) recipients respond poorly to polysaccharide antigens , rendering them susceptible to severe infections because of encapsulated bacteria . This study evaluated the responses of 127 HCT patients , median age 23.0 years , vaccinated with PNCRM7 and Haemophilus influenzae ( HIB ) conjugate , 2 conjugate vaccines highly immunogenic in healthy children .  Median time to vaccination was 1.1 years after HCT . Sixty-two percent of patients responded to PNCRM7 ( 45 of 51 children , 34 of 76 adults , P < .001 ) . Overall response to HIB was 86 % , including 77 % of PNCRM7 nonresponders . Although PNCRM7 response was adversely affected by older age ( P < .001 ) , individuals > or = 50 years old responded significantly better if vaccinated following acquisition of specific minimal milestones of immune competence , CD4 > 200/microL , IgG > 500 mg/dL , PHA within 60 % lower limit of normal ( 11 of 19 versus 0 of 8 , P < .006 ) . A similar trend was observed in patients with limited chronic graft-versus-host disease ( cGVHD ) .  In all patients , higher levels of circulating CD4(+)CD45RA cells correlated with improved PNCRM7 response . These data demonstrate that PNCRM7 is immunogenic in allogeneic HCT patients , including older adults , but suggest that vaccination at fixed intervals after HCT , irrespective of immune competence , may limit its effectiveness . Prospect i ve , multicenter trials assessing the best strategy to administer this vaccine and its impact on pneumococcal infections following transplantation are warranted Patients undergoing autologous hematopoietic stem cell transplantation ( autoHCT ) are at increased risk for infection with Streptococcus pneumoniae and have impaired antibody responses to pneumococcal polysaccharide vaccines . We performed this study to examine the ability of autoHCT patients to respond to a heptavalent pneumococcal conjugate vaccine ( PCV7 ) given after transplantation and to determine whether there was a potential benefit of immunizing these patients before stem cell collection . Sixty-one patients scheduled for autoHCT were r and omized to receive either PCV7 or no vaccine before stem cell collection . After stem cell reinfusion , all study patients were immunized with PCV7 at 3 , 6 , and 12 months . Pneumococcal immunoglobulin G antibody concentrations were measured at the time of each immunization and 1 month after the 12-month dose . Serotype-specific pneumococcal antibody concentrations were significantly higher in patients immunized with PCV7 before stem cell collection compared with patients not immunized before their stem cells were collected for 6 of 7 serotypes at 3 months , 6 of 7 serotypes at 6 months , 4 of 7 serotypes at 12 months , and 3 of 7 serotypes at 13 months . After the 3-dose series of PCV7 after autoHCT , > 60 % of study patients had protective concentrations of antibody to all 7 vaccine serotypes regardless of immunization before stem cell collection . Pneumococcal conjugate vaccine is immunogenic in autoHCT patients and may be an effective strategy to prevent invasive disease after transplantation In 27 patients r and omized to receive commercial trivalent influenza vaccine ( TIV ) containing 15 microg of the hemagglutinin ( HA ) of influenza A ( H3N2 and H1N1 ) and B virus or a recombinant vaccine ( rHAO ) containing 15 , 45 , or 135 microg of each HA , reactogenicity was minor . Among patients with similar prevaccination titers , 40 % given 45 microg and 60 % given 135 microg of rHAO developed an increase in influenza A/H3 neutralizing antibody levels ; there were no increases in 4 given TIV . For each vaccine , the highest frequencies of increases in neutralizing antibody levels and the highest mean titers occurred in those given the 135- microg vaccine The serum antibody responses of splenectomized patients with non-Hodgkin 's lymphoma ( NHL ) who had been immunized with a polyvalent pneumococcal vaccine ( Pneumovax 23 )  were evaluated by an enzyme-linked immunosorbent assay with the 23-valent pneumococcal vaccine as the antigen . A response to immunization , defined as a twofold-or-higher rise of the prevaccination titer of antibodies against Streptococcus pneumoniae polysaccharide , was elicited in 5 of 11 patients with NHL . No significant difference in the level of antibodies against S. pneumoniae polysaccharide between lymphoma patients and patients who had undergone splenectomy for other reasons was detected ( P = 0.83 and 0.87 before and after vaccination , respectively ) . NHL patients who did not respond to the first immunization received a booster dose of the polysaccharide vaccine . This injection did not increase the pneumococcal-antibody titer significantly ( P = 0.7 ) . We conclude that vaccination with pneumococcal polysaccharides in splenectomized patients with 
    Output:
    