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(HealthNewsDigest.com) – PITTSBURGH, April 9, 2021 – People with cancer that affects the blood, bone marrow or lymph nodes are at elevated risk of COVID-19 vaccine failure, particularly those with chronic lymphocytic leukemia, according to new results from an analysis of UPMC Hillman Cancer Center patients.
The finding prompted University of Pittsburgh School of Medicine and UPMC clinician-scientists to issue a cautionary statement in the preprint journal medRxiv, urging such patients and those who interact with them to take the COVID-19 vaccines available, but to continue wearing masks and practicing social distancing, even after full vaccination. They simultaneously are pursuing peer-reviewed publication of the findings.
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| Credit: University of Pittsburgh |
| Ghady Haidar, M.D. |
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“As we see more national guidance allowing for unmasked gatherings among vaccinated people, clinicians should counsel their immunocompromised patients about the possibility that COVID-19 vaccines may not fully protect them against SARS-CoV-2,” said senior author Ghady Haidar, M.D., UPMC transplant infectious diseases physician and assistant professor in Pitt’s Department of Infectious Diseases. “Our results show that the odds of the vaccine producing an antibody response in people with hematologic malignancies are the equivalent of a coin flip.”
Haidar cautioned that a negative antibody test does not necessarily mean that the patient lacks protection from the virus. At this time, UPMC and the U.S. Centers for Disease Control and Protection do not recommend repeat or booster vaccinations for previously vaccinated people, even if they test negative for antibodies.
Hematologic malignancies are a classification of non-solid tumor cancers, including leukemias, myelomas and lymphomas. These patients have a greater than 30% risk of death if they contract COVID-19 and often receive antibody-depleting therapies, which means they should be prioritized for COVID-19 vaccination. However, they were excluded from COVID-19 mRNA vaccine trials, so data on the vaccines’ effectiveness are nonexistent.
Approximately three weeks after their final vaccination, 67 patients with hematologic malignancies who had been vaccinated with either the Pfizer or Moderna COVID-19 two-dose vaccines had their blood tested. Haidar and his colleagues found that more than 46% of the participants had not produced antibodies against SARS-CoV-2.
Moreover, only three in 13 patients with chronic lymphocytic leukemia (CLL)—a slowly progressing cancer of the blood and bone marrow—produced measurable antibodies, even though 70% of them weren’t undergoing any form of cancer therapy.
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| Credit: UPMC |
| Mounzer Agha, M.D. |
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“This lack of response was strikingly low,” said Mounzer Agha, M.D., the study’s lead author and a hematologist at UPMC Hillman Cancer Center. “We’re still working to determine why people with hematologic malignancies—particularly those with CLL—have a lower antibody response and if this low response also extends to patients with solid tumors.”
The team did not find a link between cancer therapy and antibody levels to indicate why some of the patients did not mount an adequate immune response to the vaccine. As expected, however, older patients were less likely to produce antibodies compared to younger patients.
“It’s critically important for these patients to be aware of their continued risk and to seek prompt medical attention if they have COVID-19 symptoms, even after vaccination,” Agha added. “They may benefit from outpatient treatments, such as monoclonal antibodies, before the illness becomes severe.”
Additional authors on this research are Maggie Blake, R.N., Charles Chilleo and Alan Wells, M.D., D.MSc., all of UPMC or Pitt.
To read this release online or share it, visit https://www.upmc.com/media/
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About UPMC
A $23 billion health care provider and insurer, Pittsburgh-based UPMC is inventing new models of patient-centered, cost-effective, accountable care. The largest nongovernmental employer in Pennsylvania, UPMC integrates 92,000 employees, 40 hospitals, 700 doctors’ offices and outpatient sites, and a 4 million-member Insurance Services Division, the largest medical insurer in western Pennsylvania. In the most recent fiscal year, UPMC contributed $1.4 billion in benefits to its communities, including more care to the region’s most vulnerable citizens than any other health care institution, and paid more than $800 million in federal, state, and local taxes. Working in close collaboration with the University of Pittsburgh Schools of the Health Sciences, UPMC shares its clinical, managerial, and technological skills worldwide through its innovation and commercialization arm, UPMC Enterprises, and through UPMC International. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside among the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals. For more information, go to UPMC.com.
About UPMC Hillman Cancer Center
UPMC Hillman Cancer Center is the region’s only National Cancer Institute-designated Comprehensive Cancer Center and is one of the largest integrated community cancer networks in the United States. Backed by the collective strength of UPMC—which is ranked No. 15 for cancer care nationally by U.S. News & World Report—and the University of Pittsburgh School of Medicine, UPMC Hillman Cancer Center has nearly 70 locations throughout Pennsylvania, Ohio, New York, and Maryland, with cancer centers and partnerships internationally. The more than 2,000 physicians, researchers, and staff are leaders in molecular and cellular cancer biology, cancer immunology, cancer virology, biobehavioral cancer control, and cancer epidemiology, prevention, and therapeutics. UPMC Hillman Cancer Center is transforming cancer research, care, and prevention—one patient at a time.
About the University of Pittsburgh School of Medicine
As one of the nation’s leading academic centers for biomedical research, the University of Pittsburgh School of Medicine integrates advanced technology with basic science across a broad range of disciplines in a continuous quest to harness the power of new knowledge and improve the human condition. Driven mainly by the School of Medicine and its affiliates, Pitt has ranked among the top 10 recipients of funding from the National Institutes of Health since 1998. In rankings recently released by the National Science Foundation, Pitt ranked fifth among all American universities in total federal science and engineering research and development support.
Likewise, the School of Medicine is equally committed to advancing the quality and strength of its medical and graduate education programs, for which it is recognized as an innovative leader, and to training highly skilled, compassionate clinicians and creative scientists well-equipped to engage in world-class research. The School of Medicine is the academic partner of UPMC, which has collaborated with the University to raise the standard of medical excellence in Pittsburgh and to position health care as a driving force behind the region’s economy. For more information about the School of Medicine, see www.medschool.pitt.edu.