CLL Meets COVID Vaccines/ Dr. Brian Koffman's take

[bkoffman]

There is promising news about COVID-19 vaccines, but does that news apply to those of us with CLL? The Moderna and Pfizer vaccines are made with a new technology that uses messenger or mRNA that teaches our cells to recognize SARS-CoV-2’s spike protein and thus prevent infection. The live Oxford/AstraZeneca vaccine is also a new type of vaccine, made from a virus that causes colds in chimpanzees and has been genetically modified not to replicate in humans and to carry into our immune cells the SARS-CoV-2’s spike protein that confers immunity. Dr. Koffman shares what we know, what we don't know and next steps here. cllsociety.org/2020/11/dr-k...

[MaxSmart]

Great information. Thank you!

[Peggy4]

Thank you Brian.Peggy 😀

[Eucalyptus22]

Thank you.

[johnl]

I'm no Dr., but it seems to me that we will all respond differently. Newly dxed CLLers who still have some good b cells may be able to produce antibodies. While patients such as myself who just reached UMRD won't be able to produce antibodies. From what I've read these mRNA vaccines will produce some T cell response for us, but I don't think it's a get out of jail free card for us.

The best thing I've seen for us is the Regeneron antibodies which as I understand it attack the COVID directly without relying of our immune system. Good luck getting those.

john

[cajunjeff in reply to johnl]

I think you are right in that we will all have different responses to the vaccine, some better than others. I don't think being mrd negative means you have no functioning white blood cells. We have had a few anecdotal stories on here of people with advanced cll still doing okay with covid, so they must be getting some immune help from their body. There is so much we do not know about covid, even our blood type might provide protection.

There are two monoclonal antibody drugs approved and our little hospital just got a small supply. I have seen one of the hospital protocols for who qualifies for monoclonals. Having cll gets me high on the list I saw. We have to act fast because once hospitalized, we are no longer eligible for monoclonals, at least under the protocol I saw.

No one who took the moderna vaccine got severe covid, the very few in the vaccine group that did get covid all had mild cases. This tells me that even with my compromised immune system, my body might muster enough immune response to the vaccine to give me some protection.

[bkoffman CLL CURE Hero]

Being uMRD does not necessarily mean that one does not have normal functioning B cells capable of making antibodies. It depends on how and when one got to uMRD. If it was recently with an antibody like rituximab or CAR-T, then odds are poor you have any healthy B cells. if it was a few years ago or from Venetoclax or a BTKi or even a remote FCR or a transplant, you might be just fine.

[johnl in reply to bkoffman]

It was 2 mos ago from VI trial.

john

[bkoffman CLL CURE Hero in reply to johnl]

Should be pretty good

[LynnB1947]

Thanks for the info Dr. Brian. It's exciting to hear that you are working with others to get a vaccine trial started for CLL patients. (6+ years on ibrutinib for SLL here)

LynnB

[ornstin]

Thank you for this informative post.

You say that the Astra Zeneca vaccine is "live". Does this mean it would not be suitable for people with CLL? I think I remember reading advice to the effect that we should avoid live vaccines.

Antony (NB I live in the UK)

[bkoffman CLL CURE Hero in reply to ornstin]

No data, so until there are safety data or more expert guidance, I personally would steer clear. That said Pfizer and Moderna are first in human mRNA vaccines with zero longterm data.