Mounzer Agha
PITTSBURGH, Pa. People with cancer affecting the blood, bone marrow or lymph nodes are at increased risk for COVID-19 vaccine failure, especially those with chronic lymphocytic leukemia, according to new results from a study by UPMC Hillman Cancer Center patients.
The finding prompted the University of Pittsburgh School of Medicine and UPMC clinician scientists to issue a warning statement in the preprint journal medRxiv, urging such patients and those in conversation with them to report the COVID-19 vaccines available, but to still wear and practice masks. social distance, even after full vaccination. At the same time, they are engaged in a peer-reviewed publication of the findings.
“As we see more national guidelines enabling unmasked events among vaccinated individuals, clinicians should advise their immunocompromised patients on the possibility that COVID-19 vaccines may not protect them against SARS-CoV-2,” according to senior author, dr. Ghady Haidar, doctor of UPMC transplants infectious diseases and assistant professor in Pitt’s Department of Infectious Diseases. “Our results show that the chance of the vaccine producing an antibody response in people with haematological malignancies is equivalent to a coin.”
Haidar warns that a negative antibody test does not necessarily mean that the patient is not protected from the virus. At present, UPMC and the US Centers for Disease Control and Prevention do not recommend repeat or promotion vaccinations for people who have been vaccinated before, even if it is negative for antibodies.
Hematological malignancies are a classification of non-solid tumor cancers, including leukemia, myeloma and lymphoma. These patients have a greater risk of dying than 30% if they contract COVID-19 and often receive antibody-degrading treatments, which means that they should be given preference for COVID-19 vaccination. However, they were excluded from COVID-19 mRNA vaccine trials, so there are no data on the efficacy of the vaccines.
Ghady Haidar
Three weeks after their final vaccination, 67 patients with haematological malignancies vaccinated with the Pfizer or Modern COVID-19 two-dose vaccines had their blood tested. Haidar and his colleagues found that more than 46% of the participants did not produce any antibodies against SARS-CoV-2.
In addition, only three of the 13 patients with chronic lymphocytic leukemia (CLL) – which is slowly progressing to blood and bone marrow cancer – produced measurable antibodies, although 70% of them had not undergone any form of cancer therapy.
“This lack of response was remarkably low,” says Mounzer Agha, MD, lead author of the study and a hematologist at the UPMC Hillman Cancer Center. “We are still working to determine why people with haematological malignancies, especially those with CLL, have a lower antibody response and whether this low response also has patients with solid tumors.”
The team found no association between cancer therapy and antibody levels to indicate why some of the patients did not have an adequate immune response to the vaccine. As expected, however, older patients were less likely to produce antibodies compared to younger patients.
“It is critical that these patients are aware of their ongoing risk and that they should seek immediate medical attention if they have COVID-19 symptoms, even after vaccination,” Agha added. “They can benefit from outpatient treatments, such as monoclonal antibodies, before the disease becomes serious.”
Additional authors on this research are Maggie Blake, RN, Charles Chilleo and dr. Alan Wells, all UPMC or Pitt.
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Mounzer Agha
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Ghady Haidar