Expert Answers to Frequently Asked Questions A... - CLL Support

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Expert Answers to Frequently Asked Questions About Chronic Lymphocytic Leukemia and COVID-19, including vaccination

Jm954
Jm954Administrator

Interesting 'conversation' with CLL experts on a variety of topics including:

Do patients with CLL have worse outcomes if they develop COVID‑19?

Are data available on COVID-19 outcomes in younger patients with CLL?

Would it be possible for CLL-associated lymphocytosis to counteract COVID-19–associated lymphopenia in patients with CLL who are not receiving treatment?

Minimizing Risk and Treating COVID-19 in Patients With CLL

Are patients with CLL at greater risk for becoming infected with SARS-CoV-2?

Selecting Treatment for CLL in the COVID-19 Era

When would you hold therapy in a patient with CLL who has asymptomatic COVID‑19

Clinical Considerations Surrounding BTK Inhibition and COVID-19 in Patients With CLL

Implications of COVID-19 Vaccination in Patients With CLL

Answers and much more here: clinicaloptions.com/infecti...

Jackie

11 Replies
oldestnewest

Hi JackieCannot access this unless I tell porkies.

Is there a way around it.

Sue

Jm954
Jm954Administrator in reply to wroxham-gb

Sorry Sue, I did realise that. It's up to you but I looked at the page as a guest rather than register and then chose the qualifications closest to mine. There is lots of really good information there and unfortunately, it's too long to post.

Jackie

wroxham-gb
wroxham-gb in reply to Jm954

Very good Jackie. As stated now read.Lots of information there.

Stay safe.

Sue

They have Other as an option for Degree- and None as an option under Medical - that’s how I got in

Thank you for your quick response.Appreciated. Have now read and digested.

Stay safe.

Sue

Newdawn
NewdawnAdministrator

Interesting discussion Jackie 👍

Newdawn

An excellent article to put it mildly, essential reading for patients like myself who 100% participate in my own CLL trajectory, and therefore need to know the options and reasoning behind any therapeutic offers or requirements..

Thank you. Interesting reading. I told no lies, just entered ‘other’.🤣Peggy

Jackie, as long as I've been on the CLL boards , 19 yrs or so , back to the days of Terry Hamblin, its been said that vaccines just don't work so well in CLL patients.I don't see why this Covid vaccine will be any different. It's probably a good idea for everyone to get it, there may be some protection, but if CLLers think they are immune to the virus because of the vaccine and let down there guard it may do more harm than good. I think some of the Dr.s are giving that impression

john

AussieNeil
AussieNeilAdministrator in reply to johnl

Hi John,

Given that even for healthy people, no one knows how long the protection from different coronavirus vaccinations will last, no doctor should be giving this impression. I actually see CLL specialists appropriately advising us to still take care after vaccinations, with regard to mask wearing, social distancing, hand washing, etc.

For those not prepared to log in, John Pagel's answers on this topic are quite relevant:

Are there any known risks or benefits from IVIg for patients with CLL who have recovered from COVID-19?

Once patients have recovered, we hope that they will have developed their own antibodies against SARS‑CoV‑2. Some patients with CLL and COVID-19 may not mount an adequate long‑term IgG response. Indeed, a single-center retrospective analysis reported that anti–SARS-CoV-2 IgG development occurred in 67% of patients with CLL vs nearly 100% of immunocompetent patients.[9] However, the clinical implications of an inadequate IgG response remain to be determined.

I do think that most patients will generate sufficient immune response, but if a patient were profoundly hypogammaglobulinemic, I would probably continue administering IVIg. I consider the risk to be relatively low and I would encourage subcutaneous administration.

If a COVID-19 vaccine becomes available, will it be useful in patients with CLL?

I highly anticipate and am hopeful that a COVID-19 vaccine will be effective in our patients with CLL. These therapies will be initially genetic material (mRNA)–based vaccines, and this type of vaccine will unlikely be risky in a patient with CLL. Nonetheless, most all CLL patients will likely be appropriate for the vaccine, while taking into account both their disease and their CLL therapy.

Along with this reply:

Should the high-dose quadrivalent flu vaccine be administered to patients with CLL who are younger than 60 years of age?

Jacob D. Soumerai, MD:

There are data on the efficacy of flu vaccines in patients with CLL and specifically those receiving a BTK inhibitor. Flu vaccination seems to be effective in this population, although there is ongoing debate on whether there is decreased efficacy in some patients with CLL as well as with specific therapies (eg, ibrutinib).[10,11] The efficacy of other common vaccines in CLL has been investigated as well.[12]

Neil

AussieNeil
AussieNeilAdministrator

Well worth pinning due to all the excellent CLL specialist advice in your reference.

Thanks!

Neil

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