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放化疗会对淋巴细胞产生巨大损伤，那么是不是生病前积累的记忆型B细胞也遭到损伤。很多免疫应答都需要重新建立，打对应的疫苗?@橙色雨丝

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[size=1.85]Recipients of Hematopoietic Cell Transplants

A hematopoietic stem cell transplant (HSCT) results in immunosuppression because of the hematopoietic ablative therapy administered before the transplant, drugs used to prevent or treat graft-versus-host disease, and, in some cases, from the underlying disease process necessitating transplantation (35-37). HSCT involves ablation of the bone marrow followed by reimplantation of the person’s own stem cells or stem cells from a donor. The ablation caused by the HSCT will also gradually remove immune memory from previous vaccination. Antibody titers to vaccine-preventable diseases (e.g., tetanus, poliovirus, measles, mumps, rubella, and encapsulated bacteria) decrease 1-4 years after autologous or allogeneic HSCT if the recipient is not revaccinated. HSCT recipients of all ages are at increased risk for certain vaccine-preventable diseases, including diseases caused by encapsulated bacteria (e.g.,  pneumococcal and Hib infections). As a result, HSCT recipients who received vaccines prior to their HSCT should receive repeat doses routinely after HSCT, regardless of the source of the transplanted stem cells (35-37).

造血细胞移植接受者

造血干细胞移植（HSCT）会导致免疫抑制，因为移植前进行的清髓性治疗，用于预防或治疗移植物抗宿主病的药物，以及在某些情况下，还因为导致移植的原发疾病（35-37）。HSCT要做清髓性的预处理，然后重新植入患者自己的干细胞或捐献者的干细胞。HSCT时所作的清髓预处理会逐渐消除以前接种疫苗的免疫记忆。如果受体未再次接种疫苗，自体或异体HSCT后1-4年后，疫苗可预防的疾病（如破伤风、脊髓灰质炎病毒、麻疹、腮腺炎、风疹和包膜细菌）的抗体滴度会降低。所有年龄段的HSCT患者患某些疫苗可预防疾病的风险会增加，包括由包膜细菌引起的疾病（如肺炎球菌和Hib感染）。因此，在HSCT之前接受过疫苗接种的HSCT患者应在HSCT后常规接受重复接种，无论移植的干细胞来源是什么（35-37）。

以上摘自美国CDC。一般来说，常规的放化疗对抗体滴度影响不大，但移植时所作的大剂量化疗影响很大，因为记忆性B细胞主要在骨髓中，所以推荐在移植后重新接种疫苗。

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