Join us as we speak to Dr. Lee Greenberger, the Chief Scientific Officer of The Leukemia & Lymphoma Society, and Dr. Larry Saltzman, the Executive Research Director of the LLS Patient Registry.
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The Bloodline with LLS has a new episode! In this episode, Dr. Greenberger and Dr. Saltzman provide important updates on the continued COVID-19 pandemic, the LLS Antibody Research Study, patients' responses to the COVID vaccines, and additional methods of protection. Be sure to tune in to these important updates as LLS strives to protect patients.
As part of LLS’s COVID-19 Response Program, this podcast episode is supported in part by BeiGene, Bristol Myers Squibb, Kite, A Gilead Company, Pfizer and Pharmacyclics, An AbbVie Company & Janssen Biotech.
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Snips, but it really is well worth watching or reading the full video/transcript:
Natural vs Vaccine Immunity, why Variants arise
Dr. Saltzman: I think in the end what we have to understand is that these spike antibodies to COVID really are essentially the same, whether they're produced by the body's response to the vaccine or to the infection. And since we're on the topic of blood cancer patients and their responses, if one person is a blood cancer patient and becomes infected with COVID, potentially one of the reasons that they are sicker than other people is because they don't have the engine or the lymphocytic cells to actually produce the antibodies. That's part of the problem.
So if the vaccine is not going to produce antibodies, it's also likely that a person who's been treated with these drugs, therapies that I just mentioned, they're also not going to be able to produce antibodies. So there's a duality here that we have to really keep in mind.
Lizette: Right, and a lot of our patients are really asking us, what's better for me to get the vaccine or if I get COVID, will my body produce those natural antibodies? So what can you tell our patients?
Dr. Saltzman: Well, look, you noted that I'm a CLL patient and so I'm very clear that I do not want to test my system and go to a chickenpox-like party and get infected with COVID. There is no way I want to do that.
So people should become vaccinated. Our mantra is get vaccinated, act unvaccinated;
and I think it's not even thinkable to believe that getting a COVID natural infection in an immune-compromised person is anything that we want to even think about, frankly.
Elissa: And there's also the risk of long COVID, right?
Dr. Greenberger: Yeah, that's true. In fact, some of the variants that have come out actually have been the result of blood cancer patients getting infected. Having a long-term infection, where a normal individual could resolve an infection in a matter of 10 or 14 days, some of the blood cancer patients, because they are not making antibodies against the COVID infection, will have the viral infection for weeks or months. And that is a perfect breeding ground for viruses to make mutations. That's what viruses do. They're natural evolution. Their ability to survive is based on the ability to change.
And that's where Wuhan variant, Delta variant, Omicron variant, that's what viruses do, they change. And so in a long-term infection, the danger is a variant could appear.
We know this has been happened in blood cancer patients. And so it's not only bad for the patient, it's bad for the whole community to have anybody with a long-term infection.
Now long-term COVID could be, even after the infection is cleared, what we're beginning to see is there's long-term consequences of getting an infection. So COVID may be over, but the damage that COVID has caused may go on for many months.
Fourth Dose?
Dr. Greenberger: I will say we don't have fourth data responses yet. We are anticipating that there will be some increase in anti-spike levels. There are some studies in solid organ transplant patients who are also immunosuppressed showing that there is a response, an increase in antibody levels after the fourth shot.
However, data coming out of Israel suggests, at least in normal patients, that the fourth shot is not going to give you the same kind of boost that you got from the third shot. I think the immune system just says, "Hey, I've seen that before." That's kind of like you turned me on for the max by the third or fourth dose. And so, yeah, you may get some benefit, but you're probably not going to get the same kind of increase in anti-spike or increase in protection that you got from the second and third dose.
Prevention?
Dr. Saltzman: So let me start with a disclaimer if I can, and I'll let Lee get into the science. But the disclaimer is that Evusheld is referred to as a preventative monoclonal antibody. The truth is that we cannot prevent anybody from inhaling the COVID virus, and we can't really prevent that virus from taking a foothold in somebody's respiratory passages, be it their nose, their throat, or their lungs.
The preventative aspect of this is to keep a person out of the hospital and to keep a person out of a serious, significant infection so that it doesn't hurt them. And I think the idea that we can prevent COVID is really using a phrase that I fear a little bit, because we can't prevent it. We can lessen the effects. We cannot prevent it.
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Dr. Greenberger: So clearly blood cancer patients need to be cautious, even with the masks coming off. Certainly, if you know you're not making antibodies, you really need to be very careful. It would be still a good idea to wear a mask, a good idea to do the rapid test. Make sure everybody is vaccinated around you. I think you still have to keep up your guard.
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