This study is specific to us, and there are no surprises! (Don't think I have see this before on this site).
In this study of 167 patients with CLL, only four out of 10 (39.5%) had a positive antibody-mediated response to the vaccine; all healthy adults (controls), by comparison, marshalled an immune response.
Try this ...
ashpublications.org/blood/a...
Click on PDF link ....
None of the patients tested had developed a COVID infection at 75 days. Not sure how to interpret that.
Nice study, thank you for sharing that!
That's consistent with other reports, such as this, with my emphasis:
People with cancer that affects the blood, bone marrow or lymph nodes are at elevated risk of COVID-19 vaccine failure, particularly those with chronic lymphocytic leukemia, according to new results from an analysis of UPMC Hillman Cancer Center patients.
The finding prompted University of Pittsburgh School of Medicine and UPMC clinician-scientists to issue a cautionary statement in the preprint journal medRxiv, urging such patients and those who interact with them to take the COVID-19 vaccines available, but to continue wearing masks and practicing social distancing, even after full vaccination. They simultaneously are pursuing peer-reviewed publication of the findings.
“As we see more national guidance allowing for unmasked gatherings among vaccinated people, clinicians should counsel their immunocompromised patients about the possibility that COVID-19 vaccines may not fully protect them against SARS-CoV-2,” said senior author Ghady Haidar, M.D., UPMC transplant infectious diseases physician and assistant professor in Pitt’s Department of Infectious Diseases. “Our results show that the odds of the vaccine producing an antibody response in people with hematologic malignancies are the equivalent of a coin flip.”
Haidar cautioned that a negative antibody test does not necessarily mean that the patient lacks protection from the virus. At this time, UPMC and the U.S. Centers for Disease Control and Protection do not recommend repeat or booster vaccinations for previously vaccinated people, even if they test negative for antibodies.
:
...only three in 13 patients with chronic lymphocytic leukemia (CLL)—a slowly progressing cancer of the blood and bone marrow—produced measurable antibodies, even though 70% of them weren’t undergoing any form of cancer therapy.
upmc.com/media/news/040921-...
Neil
To me this is a welcome study, bringing into sharper focus the antibody responses of CLL patients to vaccination. The sample size has enabled the authors to classify the subject population and relate antibody response to disease stage, treatment etc. At one end of the scale are those treated and at least one year in remission, or untreated at an early stage of disease - the great majority get a response.
At the other end of the scale are those recently (less than one year) treated with a CD20 drug like Rituxan or Gazyva - they get "nul points" between them. That's me 😕 but at least now I don't need to bother getting an antibody test 😊
The next stage of the study will look at cellular responses. That could be more complicated to investigate and to analyse, but important for us to know more about.
This is (IMO) the best study to date. They break down the CLL patients into groups. I've never seen that do date.
They have a bona-fide control group. Clean science.
What no one has looked at yet is which groups will be (more or less) susceptible to breakthrough COVID -- and how bad their disease becomes. You never know - perhaps all of us will still have a good shot at mild or moderate COVID at the worst!
These authors acknowledge what they cannot conclude - and that is always the best thing to see in a journal article.
Agreed. This is our reference study for the time being. I'd like to know what was the relationship between Ab response and PB cell counts.
Incidence of post vax breakthrough Covid is one thing that the LLS register will elucidate
Let's keep in mind that the study states second doses were given 3 weeks from the first dose. In Britain second doses are being given 12 weeks after the first dose, and in Canada, second doses are extended to at least 16 weeks. I wonder what level of protection patients will achieve with these vaccine dosing schedules.
Sandy Beaches
The Com-Cov study will look at 3 and 12 week dosing intervals for 3 vaccines given in different combinations comcovstudy.org.uk/home
Good and helpful interpretation I think.
Thank you. That was a clear report to read.I suppose we should be thankful that these studies are being done; the more information, the better.
Thanks again.
Stay safe,
Fran 😉
Thank you for sharing.. quite interesting!As i am on Ibrutinib (Imbruvica) would that be interpreted as I am under treatment category; hence, I am more vulnerable even with Vaccine?
Would antibodies test like the Hig,.. be a good was to measure the level of my response?
Thanks much!
They did give figures for in-treatment with BTKi. Not so good an Ab response. Where Ibrutinib may help is in restoring T cell function, for which there is some evidence.
Although I digress, the ability of ibrutinib to improve T cell function is being utilized to improve outcomes in CAR-T therapy by bolstering T cell function.
Thank you dear for your response.. honestly, I am not familiar with the abbreviations you used in your answer ! 
Sorry, we do tend to over-abbreve here! Ibrutinib is a BTKi = Bruton Tyrosine Kinase inhibitor (so are Acalabrutinib and others).
The Israeli study found that few CLL patients in active treatment (16 %) had a positive antibody (Ab) response to two doses of Pfizer vaccine, regardless of the kind of treatment they were on, including BTKis.
T cell response is harder to analyse, but some experts believe it to be as or more important in protecting against severe illness with Covid. 😊
The author is my specialist and they are currently studying T cell response (I gave my blood and am awaiting results) in the CLL population. Will post once I get an update on it
Great thanks, looking forward to hearing from you again.
RE; Antibody response to vaccination -
For those of us who remember the late great Dr Terry Hamblin; he and his team were debating the efficacy of the INFLUENZA vaccine for CLL patients back in 2006, having noted the lack of antibody response in a % of his CLL patients to THAT virus. They were proposing various strategies to enhance the response to that virus. How time flies.At one stage there was a proposed clinical trial as below
- historical interest only
mutated-unmuated.blogspot.c...
Interesting that nearly 15 years ago TH highlighted the importance of vaccinating cohabitants of CLL patients.
UK implemented this for Covid19 just days ago.
Interesting article thanks for posting it. It does just relate to the MRNA vaccine-specifically Pfizer. Many of us in the UK have had the Astra Zeneca vaccine which is a vector virus. I (think!) I read somewhere this last week that AZ was giving a slightly better T cell response. I think the Birmingham University study will tell us more in due course about both types of vaccine efficacy in CLL.
Wait for the studies to tell us about T cell responses in CLL patients. What goes for the herd (people without profound disruption of the immune system) will not apply to the majority of us. The Israeli study will look at this next.
Once confounding factors are taken into account, my guess is we'll see very similar response patterns in CLL with all RNA vaccines.
The author is my specialist and they are currently studying T cell response (I gave my blood and am awaiting results) in the CLL population. Will post once I get an update on it
Thanks for ruining my day. 😀 On a positive note, I'm still on watch and wait. 6 weeks after my second vaccination I had an antibody test which was positive, so at least I am above some minimum threshold for sure
For what it’s worth: I had no immediate reaction to either Phizer vaccine injection. However, I had an IVIG infusion 6 days after the second injection. The next day I began experiencing cold symptoms including low grade fever and generally feeling yucky. I had planned to call my GP for an appointment the next day but I woke up symptom free. I happened to have a scheduled wellness exam a couple of weeks later. My GP suggested that the IVIG triggered an immune response. I will ask my hematologist about it later this month.
Excellent info. I continue to believe that the immune compromised need a prophylactic that does not depend on antibody response. Doesn’t that simply make sense? Right now the drug of this nature, Molnupiravir, is farthest along in development. There are others also being developed as well. While apparently not a suitable therapy once you have progressed to a serious stage of illness, neither of course is a vaccine. The prophylactic studies for Molnupiravir are to be conducted later this year. I personally use Hesperidin which is over the counter. There is a scientific rationale for doing so along with a few studies and trials. See links below. What drives the extent of such things is whether patents are available since this is the means to covering development costs, paying for studies, and generating a return for investors. Hesperidin may not be attractive in these ways. But it is nevertheless what I personally will continue to do because it has kept me free of infection for a year in a poorly isolated environment. My status is watch and wait. But as the Israeli vaccine study cited indicates, it matters whether you are on watch and wait or in treatment as well as the length of time that has passed since completion of treatment. In any case, and particularly if you are unlikely to respond well to the vaccine, please be aware that your path to living more socially while avoiding COVID, and perhaps (hopefully) even the seasonal flu, may in the near future not be solely dependent on the extent of your capacity to elicit an antibody response.
Molnupiravir
news.yahoo.com/merck-plans-...
Hesperidin
pubmed.ncbi.nlm.nih.gov/328...
pubmed.ncbi.nlm.nih.gov/325...
Anti-body tests do not necessarily prove or disprove that the vaccines for covid are or are not effect. mdanderson.org/cancerwise/w...
I joined an Antibody study for CLLers and sorry to say two doses of Pfizer and no detectable antibodies. Now I am about to start treatment next week so maybe my advanced stage had something to do with it. I'll be the one with the mask in the corner while the world gets on with their lives. Oh well, just another bump in the road.
UK: Here’s a list of people who are eligible for the 3rd dose of Covid vaccine. Mixed Oxford/Pfizer vaccine schedules generate robust immune response against COVID-19, finds Oxford-led study
Leukemia Lymphoma Society Study
It’s official Study shows T cells are activated against Covid after vaccination 
ITP secondary to CLL TX hi-dx dexamethasome Response
