Blood cancers

Early data unpicks COVID-19 vaccine effectiveness in lymphoma patients

Patients who have been treated for some lymphomas can develop robust antibody responses to COVID-19 vaccination – at least once their treatment is completed, say UK researchers.

But others may never achieve a vaccine response however long ago their treatment ended.

In an interim analysis of the UK PROSECO study, data from 129 patients showed that individuals with Hodgkin lymphoma and aggressive B-cell non-Hodgkin lymphoma can develop robust serological responses as early as six months after treatment.

Yet the data published in a letter in The Lancet Haematology showed that those vaccinated while receiving systemic anti-lymphoma therapy are unlikely to develop antibody responses at the time. Those patients should be revaccinated when treatment is finished, the researchers concluded.

Their findings support revaccination six months after completion of anti-CD20 containing therapy and suggest earlier vaccination may be possible in the case of non-anti-CD20 containing chemotherapy but they warn more data is needed to confirm this.

In the analysis of 129 patients with a range of lymphomas and 150 healthy volunteers, data those who had completed treatment showed that, all six participants with Hodgkin lymphoma and 13 (81%) of 16 with aggressive B-cell non- Hodgkin lymphoma developed robust antibody levels comparable to the healthy controls.

The exceptions among patients with aggressive B-cell non-Hodgkin lymphoma were recipients of CAR-T cells, said the researchers, despite them having finished treatment 11-23 months previously. Of those, all three had no detectable antibodies after the first dose, one developed antibodies after the second dose and the other two have yet to be tested, they reported.

The team also found that those with indolent lymphomas might have impaired vaccine responses whatever their treatment history and might benefit from further protective measures, such as boosting with alternative vaccines or prophylactic monoclonal antibodies against SARS-CoV-2.

Speaking with the limbic, study leader Dr Sean Lim, Associate Professor and Honorary Consultant in Haematological Oncology at the University of Southampton said while the numbers are small the outcomes for those with aggressive B-cell lymphomas and Hodgkin lymphoma were “reassuring”.

“The great majority of patients who were vaccinated whilst undergoing treatment for their lymphoma did not develop an antibody response,” she said.

“There is a definite need to revaccinate these patients after they have completed their treatment. For patients that seem to have low responses irrespective of their treatment, alternative options such as a booster with a different vaccine should be explored.”

Dr Lim added: “Patients and clinicians alike need to be particularly aware of above given the recent Government announcement with regards to lifting restrictions and making face mask a personal responsibility.

“The data within the paper defines subsets of patients who may not be sufficiently protected by the vaccines and should continue to wear a mask and maintain social distancing.”

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