ASH 2020 Day 1 Update: ASH 2020 officially started early Saturday Dec. 5th with a fireside chat between ASH president, Dr. Stephanie Lee and Dr. Anthony Fauci. Dr. Fauci shares his recommendation that immunosuppressed patients with blood cancers, like us, get the vaccine, because some immunity is better than none.
As to CLL research, there were dozens of posters on new therapies and deep dives into the biology of CLL, great education on managing the adverse events of novel agents, new research on how venetoclax effect cells beyond CLL, a promising new concept on how to treat Richter’s Transformation, but for my daily video I chose to focus on the four oral presentations on the latest clinical trial news about limited duration therapies, all of which included venetoclax. We covered the CAPTIVATE, CLARITY, MURANO and CLL14 trials.
Please enjoy some of the highlights from ASH’s official first day. I will be reporting daily and then we will be digging much deeper over the next several months.
What if post-BR (or other treatment) the lymphocyte count is ~zero ?I seem to remember suggestion that typical vaccine response (other vaccines) of the CLL immune compromise patient might be around 20%
..but if my response is likely around 1% .. I’d sooner a healthy, active, person got vaccinated, so that some real immunity were added to the herd immunity of the population.. all hospital staff for instance.. shop workers.. (long list!)
Why wouldn’t you take the vaccine? Seems crazy not to do so as there isn’t much to lose. Even with a partial response you are adding to herd immunity and protecting yourself to some extent. Also, isn’t it somewhat hypocritical to want others to re receive the vaccine but not do so yourself?
True, but the small yet extremely vocal group of "anti-vaxxers" are successfully spreading panic & distrust. They ignore that in the aggregate effect on society as a whole, vaccines have saved many many more from illness & death than the unfortunate few who react badly to a vaccine. Most of the more vocal ones are too young to remember polio. Or diphtheria.
My very best interests are in recovery after BR treatment of CLL.. ..in relation to COVID19, I perceive the best thing to reduce my risks, is herd immunity in the population...
If this were flu vaccine, a vaccine essentially in ample supply, then sure, I’d get it.. (though, to be honest, my reply was to expert Brian, to see how he reacted) ..however, COVID vaccines are going to be in very short supply for months to come..
I would sooner see the most exposed people get vaccinated and thus don’t act as vectors.. I’d like to see visits to doctors and to shops become safer..
I think a possible 0.5-1% response in me is less useful than a 70% response in a healthy person..
I’d like to see University students, in this university city, get vaccinated, so that their propensity for close contact with one another does not make them a major risk to the community, including vulnerable me.. If I had a <=1% response to vaccine, this is less likely beneficial, than cutting the local infection rate.
When my lymphocytes return, well, then it starts being more useful that I am vaccinated.. the same applies to my recent flu vaccine - it was not likely to benefit me, with risks associated with going to the appointment potentially greater than any Gainsborough.
We are in the same boat in that I had BR treatment (unfortunately) first line, too. I transferred my care to Dana Farber after my first line treatment. The experts here tell me that I should get the vaccine when it is available. So that is what I plan to do. I think you should also rely upon your professionals as these health issues are complex. Coincidentally, I received a blast email from Dana Farber today saying that “Cancer” patients are expected to be given priority for the vaccine. Details are not yet formalized but they are evidently trying to put vulnerable Cancer patients toward the front of the line for which I am extremely thankful. For a mass vaccination program to be successful people need to follow instructions and trust the experts.
Immune response can be impaired by many factors including low lymphocyte counts. When I had no B cells post CAR-T, I doubt my vaccine response would have been optimal.
Hi Shedman, I just met with my hem/onc and he advised I shouldn’t get the vaccine for similar reasons to you. I’m currently on obinutuzumab which completely wipes out b-cells (the good and bad ones). So a vaccine would be virtually useless in me. He said I should expect to get the vaccine at least a further 6 months after finishing obinutuzumab by which time some b-cells should have returned.
I appreciate your thinking about herd immunity and passing on the vaccine to get the most optimal result for society. I’m not going to get the vaccine just because I can, when it will provide virtually no protection for me. Despite other comments, I don’t think there is anything crazy about that.
I prefer the unknown risk of long term of the vaccine versus the known risk of covid so I would be 1st in line for the vaccine.
“Getting the vaccine is better than no immunity” was my first thought. I’ve since seen in the News that immunocompromised people are one of the 3 groups lacking in clinical trial data, at least for Pfizer’s vaccine.
Even if allergies were an issue, which is the news I woke up to this morning, I think I’d risk the allergies reaction over my body’s reaction to COVID.
re Pfizer vaccine "...two trial participants had died after receiving it. One of the deceased individuals was immunocompromised" They don't say what the other one death was attributed to, or the condition that caused the other volunteer to be immunocompromised. jpost.com/breaking-news/two...
And 4 in the placebo group died. Just stating "2 trial participants died" takes it out of context. The article also stated those 2 deaths did not appear to be vaccine related (however they determined that)
Have studied this a lot, am eager to be vaccinated. The benefits seem to outweigh the risks, for at risk, immunocompromised, front line medical and other workers, over 65. Perhaps others. Am budgeting a day after each shot to feel pretty bad.
Trying to accept that medium to long term effects are unknown.
Prefer the Moderna, then Pfizer.
Concerned that US has doubled down on Astra Zeneca and JNJ.
“Conclusion: RZV was associated with lower cell mediated immunogenicity in MBL/CLL participants compared to healthy older adults. Among individuals with CLL, BTKi treatment was associated with decreased cell mediated immunogenicity of the vaccine. Given the inferior response rates, an additional dose of RZV may be considered to boost responses and should be studied in this patient population.”
Doc,
I guess some response is better than none and there wasn’t any mention of vaccine related problems.
I will show this to Dr Wierda next month. Perhaps he will order another vaccination booster or maybe not.
I’m a newly diagnosed healthcare worker. On Imbruvica and feeling great so far after a challenging year. I had Covid-19 in March-thankfully a survivor but no antibodies shown to date- I spoke with my hematologist & he said as soon as I am able to get the vaccine- I should get in line and roll up my sleeve. This is my plan, I know it doesn’t work for everyone, but trust my doctor knows what is best for me. Grateful to know Dr. Fauci agrees.
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Ibrutinib and Obinutuzumab with Venetoclax
