The effect of ranitidine on antibody responses to polysaccharide vaccines in patients with B-cell chronic lymphocytic leukaemia

Objectives: To analyse the effects of ranitidine treatment on vaccination induced antibody responses in patients with chronic lymphocytic leukaemia (CLL). Methods: Fifty CLL patients were vaccinated with tetanus conjugated Hib vaccine and a 23-valent pneumococcal polysaccharide vaccine with (n = 25) or without (n = 25) ranitidine treatment in a matched case-control setting. Anti tetanus toxoid (TT), anti-Hib and anti-pneumococcal antibody levels were determined before and after vaccination. Additionally, cytokine levels were assessed in patients treated with ranitidine. Results: Vaccination-induced increases in anti-Hib and anti-TT antibody levels were higher in the ranitidine group compared with the control group. Anti-pneumococcal antibody responses were not improved by administration of ranitidine. Higher levels of IL-18 were found in patients treated with ranitidine compared with healthy controls. Levels of IL-6, IL-8, IL-18, RANTES, IP-10, sVCAM-1 and sICAM-1 were within normal ranges and did not change during ranitidine treatment. Conclusion: Ranitidine treatment improves vaccination-induced T-cell dependent antibody responses in patients with CLL but has no beneficial effect on the response to vaccination with unconjugated polysaccharide antigens.