Covid Vaccine after obinutuzumab

[atiatamer]

Hello, My dad started Venetoclax + obinutuzumab treatment July of 2020. and his last obinutuzumab infusion was 1 December 2020. (so 4 months ago), he is still on venetolax until June.

His response has been great, but he would like to get the Covid vaccine. we were told that since he was on obinutuzumab, he would have to wait for at least 3 to 6 months before he can take the vaccine, so he wouldn't have a blunted response to it.

I am wondering if there is a clearer timeline for him to take the vaccine, or if there is a test he can do to detect his readiness for the vaccine

[Flute117]

I had my last Obinutuzumab infusion in January of this year and am still on Venetoclax. My specialist felt that my immune system was in good enough shape to have the vaccine now - he had me wait at least 6 weeks after last infusion. Had my 2nd Pfizer jab two days ago and felt very ill that evening and the next day. I had chills, extreme tiredness, and headache. Woke this morning feeling mostly back to normal.

My specialist ordered a quantitative antibody test for end of May. Fingers crossed that it shows good results. I will, of course, still mask and and avoid being around the general public, but it sure would be nice to see vaccinated family members in person and maybe even share a meal. Haven’t seen my out-of-state adult daughters since Thanksgiving 2019.

I trust my doctor and given all of the unknowns surrounding SLL/CLL and the vaccines, I followed his advice. Your Dad’s doctor knows his situation best and I would do as he/she advises.

[atiatamer in reply to Flute117]

Thank you so much for the reply, I hope you get a great response and get to see your daughters and family soon and share a wonderful meal with them

[atiatamer in reply to Flute117]

Hello.. I hope you are doing well I just wanted to check back on you. Did you do the antibody test? Hope you got a good response

[Flute117 in reply to atiatamer]

Unfortunately, my test last week showed no antibodies from the vaccine. I’m so bummed because I feel fine and was hoping to start cautiously re-enter society. I did get to do an outdoor visit with one of my daughters recently, so that was nice.

How is your Dad doing? Has he gotten the vaccine?

[atiatamer in reply to Flute117]

I am sorry to hear that.. but hopefully everyone around you is getting vaccinated so you will be protected that way.My dad is fine, he should be done with Venetoclax in 2 weeks.. and we decided that he will get the vaccine then. It would be 6 months after obinutuzumab.. so hopefully it's enough time to get a response from vaccine.

Will keep you posted' maybe you can try to get a booster shot in couple of months and hopefully get a response

[AussieNeil Administrator]

If you can have an immunophenotype flow cytometry test done (in other words a repeat of the test used to diagnose your CLL), that will report how many B and T lymphocytes you have and how many of them are clonal B-lymphocytes (i.e. CLL/SLL cells). You need some healthy B- lymphocytes and ideally a healthy ratio of CD4 and CD8 T- lymphocytes as prerequisites for a response likely to produce antibodies/immunoglobulins to the vaccination. If you can't get this test done, a healthy lymphocyte count may give some indication that a vaccination may provide you with COVID-19 antibodies, but there's no way of knowing how that count is made up of CLL/SLL cells and healthy B and T lymphocytes.

Neil

[atiatamer in reply to AussieNeil]

Hello, we did the flow cytometry test, can i share it with you to get your opinion on ratio? our doc says that you cant get that answer on vaccine readiness through this test. but we still would like to see how it can be interpreted. (dont worry we just want help understanding numbers, not an official diagnosis). also does this show MRD negtivity?

[AussieNeil Administrator in reply to atiatamer]

This immunophenotype flow cytometry test looked for and couldn't find any B-lymphocytes in the 1,150 lymphocytes examined. There were no monoclonal lymphocytes detected. Modern MRD testing typically checks 10,000 cells, so it's about 9 times more demanding than this test, but this is a very good result.

Neil

[Flute117 in reply to AussieNeil]

Hi Neil,

I just got my flow cytometry results last night but have not discussed with my specialist yet.

If you or anyone else can shed some light on these results, that would be great.

In any case, I will discuss in my Telemedicine appointment on Tuesday and fill you in.

Interpretation:

PERIPHERAL BLOOD:

VIRTUALLY NO B-CELLS ARE PRESENT.

NO ABNORMAL T-CELL POPULATION IDENTIFIED

Comment: Review of peripheral blood smear show absolute lymphopenia without abnormal circulating lymphocytes.

By flow cytometry studies, gating on bright CD45 gate identifies 7% lymphocytes that are predominantly CD3 positive T-cells without significant loss of pan-T-cell antigens or downregulation and CD4:CD8 ratio of 4.9:1.

Virtually no B-cells are present for evaluation.

Overall, there is no diagnostic evidence of residual chronic lymphocytic leukemia cells seen.

[AussieNeil Administrator in reply to Flute117]

Looks like a good response from your V+O treatment, with a healthy CD4 T cell count too and more T cells on the way.

[NaturalWaze]

My CLL doc (Lamanna) has me waiting 3 mos after my last Obinutuzimab (which was just last week).

[Larkfield-UK]

Sorry to reply late, I don’t visit the site often, glad you have had good results from these drugs. My hubby also starts the same drugs on 8th July this year so I hope he gets a great result also. Keep well and all the best. Thanks for sharing the news.