Largest Study to Date Shows Most Blood Cancer Patients Receive Third Primary Dose of COVID-19 mRNA Vaccine
RYE BROOK, NY, December 13, 2021 / PRNewswire / – While one in four blood cancer patients do not produce detectable antibodies after their first two doses of the COVID-19 vaccine, 43% of them will produce antibodies after a third dose , according to new data from The Leukemia & Lymphoma Society (LLS). For some blood cancer patients, the third dose resulted in antibody levels seen in healthy adults. This was confirmed by measuring the levels of detectable antibodies against the spike protein in SARS-CoV-2 before and after the third dose of the COVID-19 mRNA vaccines. The results of the study, the largest of its kind to date, also show that patients with blood cancer who had at least some antibodies after the first two doses are likely to produce large amounts after the first two doses. third vaccination.
“Our data shows that there is a clear benefit to giving blood cancer patients three doses of the primary vaccine, but there is still a large portion of patients who will remain at risk even with the extra dose,” said Lee greenberger, Ph.D., scientific director of the LLS. In this study, about 20% (139/699) of blood cancer patients still did not have measurable COVID-19 antibodies after the third dose. The findings, which were reported on Saturday at the American Society of Hematology (ASH) annual meeting in Atlanta, are among the largest number of blood cancer patients reported to date.
The vaccines stimulate the production of anti-peak antibodies, which can block the entry of the COVID-19 virus into human cells. Having these antibodies appears to offer protection against illness or serious illness. However, for many blood cancer patients, their antibody levels may not be as strong as those of healthy, fully vaccinated adults, making them more susceptible to a breakthrough infection with COVID-19. .
The data reported by LLS comes from the LLS National Patient Registry, which has tracked the response to the COVID-19 vaccine in more than 11,000 blood cancer patients since February 2021. The LLS previously reported the results of the first and second dose of vaccination, as well as a smaller study with a third vaccination in near real time, to help blood cancer patients and their oncologists take informed decisions about vaccines and other steps they can take to prevent infection.
The current study’s largest data pool, from 699 patients, provides more solid information on how the third dose of COVID-19 mRNA works in patients with all types of blood cancer. The study does not include information on the response to the Johnson & Johnson vaccines.
The study was weighted to include more patients with blood cancers that deplete the immune system’s B cells, which are responsible for making antibodies. Patients with these types of cancer, including chronic lymphocytic leukemia, diffuse large B cell lymphomas, follicular lymphomas, marginal zone lymphomas, mantle cell lymphomas, and Waldenstrom’s macroglobulinemia, are less likely to develop antibodies. In patients who did not produce antibodies against the initial vaccination, the antibody response after the third vaccination ranged from 0% to 48%.
In contrast, the rest of the participants had myeloid forms of leukemia, Hodgkin’s lymphoma, and multiple myeloma, all of which tended to respond more favorably to the initial vaccinations as well as the third vaccination. The levels of antibodies detectable in these patients ranged from 75% to 100%.
“These results are consistent with the CDC recommendation for immunocompromised adults, demonstrating the benefit of a third dose of mRNA vaccine for patients with blood cancer as part of the primary vaccination course, with a booster dose six months later, “said Gwen nichols, MD, Chief Medical Officer of LLS. “But blood cancer patients should also remember that they are among the nearly three million Americans with weakened immune systems who may not receive optimal vaccine protection. We encourage them. patients with blood cancer to continue to take additional precautions, such as mask wear and social distancing. “
Some cancer treatments weaken the vaccine response, but it could actually be boosted
B-cell depletion treatments, including Bruton tyrosine kinase (BTK) inhibitors and anti-CD20 antibody treatments, are essential for treating some types of cancer, but they suppress the immune response either during treatment or in the case of anti-CD20 antibodies, even several months after the end of treatment. Among the patients with chronic lymphocytic leukemia (320 in this study), who are commonly treated with these therapies, 65% who had not received any therapy in the previous two years produced antibodies against the third vaccine. However, among those who received BTK inhibitors and anti-CD20 antibody treatments in the past two years, only 23% to 41% produced third dose antibodies.
In contrast, patients who receive antibody infusions as part of their normal treatment for blood cancer may gain an unexpected benefit. Intravenous immunoglobulin, or IVIG, is often given to patients on BTK inhibitors or anti-CD20 antibodies, or who have received certain treatments with CAR T cells, to replace antibodies not produced by their own B cells. Antibodies to COVID spikes in IVIGs, which are derived from blood plasma donors, have increased dramatically because more of the U.S. population has had COVID-19 or been vaccinated.
In this study, some of the patients treated with the IVIG infusion had unusually high antibody levels after a third dose of the vaccine, including some in whom no antibodies were detected after the first two doses. Although the researchers cannot rule out that the sharp rise in antibodies was due only to the third vaccine, IVIG infusions are likely to play a role.
Blood Cancer Patients Must Be Proactive In Seeking COVID-19 Vaccination And Care
Patients with blood cancer should follow the CDC’s vaccination recommendations. But because they may not receive optimal vaccine protection, they should continue to wear masks, social distancing, avoid poorly ventilated and overcrowded spaces, and encourage those around them to get vaccinated to avoid infection.
Patients with blood cancer should also immediately alert their oncologist if they come in contact with someone with COVID-19 or if they test positive for the virus. Antibody therapy can help reduce the risk of getting sick or having serious complications from COVID-19, but treatment should begin as soon as possible after exposure. In addition, the FDA this week cleared a new cocktail of monoclonal antibodies that can be used to prevent COVID-19 in immunocompromised patients who do not have an adequate immune response to vaccination.
While a lack of measurable antibodies likely means these patients have little or no protection from vaccines, vaccines can boost the immune system in other ways. Further studies are underway by LLS and others to assess other ways the immune system may respond to vaccination, for example by activating T cells.
About the LLS National Patient Registry
The LLS National Patient Registry, a project of the Michael J. Garil Patient Data Collective, was created to honor the memory of Michel garil, who was diagnosed with Acute Lymphoblastic Leukemia in 1974 at the age of 7. His parents, Ethel and Bernard Garil, generously supported the creation of the LLS National Patient Registry to collect vital information from large numbers of people affected by blood cancers. The current trial was conducted under IRB review with electronic patient consent. The data has been anonymized before being analyzed for vaccine results, and all patient records are kept strictly confidential.
About this study
The current study includes 699 patients enrolled in the National LLS Patient Registry who received a third COVID-19 vaccination between June and September 2021. Seventy-five percent of the patients in the study had forms of cancer known to dampen the immune response to COVID-19 vaccines and COVID-19 infection.
The median age of the patients was 68 years; 55% were women and 95% identified as white. As per CDC recommendations, most patients received the same vaccine (Pfizer-BioNTech or Moderna) for their third dose as for the first two. The study does not include information on the response to the Johnson & Johnson vaccine because almost all of the patients in the registry received Moderna or Pfizer vaccines.
About the Leukemia & Lymphoma Society
The Leukemia & Lymphoma Society® (LLS) is a world leader in the fight against cancer. The LLS Mission: Cure Leukemia, Lymphoma, Hodgkin’s Disease and Myeloma. LLS funds vital blood cancer research worldwide, provides free information and support services, and is the voice of all blood cancer patients seeking access to quality care, affordable and coordinated.
Founded in 1949 and based in Rye Brook, New York, LLS has regional offices all over United States and Canada. To learn more, visit www.LLS.org. Patients should contact the LLS Information Resource Center at (800) 955-4572, Monday through Friday, 9 a.m. to 9 p.m. ET.
For more information, visit lls.org/lls-newsnetwork. Follow us on Facebook, Twitter and Instagram.
The Leukemia & Lymphoma Society
SOURCE The Leukemia & Lymphoma Society