LLS.ORG (USA) Registry Study Provides New Insights about COVID-19 Vaccine and Blood Cancer Patients Ciitizen LLS National Patient Registry

[lankisterguy]

lls.org/news/study-leukemia...

As always, thanks to everyone who joined the LLS National Patient Registry, a project of the Michael J. Garil Patient Data Collective to help us generate valuable scientific information that has contributed to U.S. public health policies designed to protect blood cancer patients, especially those with weakened immune systems, from COVID-19.

Please find four (4) topics below:

• New Registry Study Provides New Insights about COVID-19 Vaccine and Blood Cancer Patients lls.org/news/study-leukemia...

• Updated (Bivalent) Vaccine Boosters Are Available Now!

• Is It Time for Your Next Dose of Evusheld?

• You Are Invited to Hear Directly from LLS and Other Experts

New Registry Study Provides New Insights about COVID-19 Vaccine and Blood Cancer Patients

With your help and support, published on September 8, 2022, the latest registry study, reports that some blood cancer patients who do not produce detectable antibodies after COVID-19 vaccination may generate another form of protection: T-cells. Both forms of immune protection are important.

High antibody levels can completely neutralize the virus, preventing it from entering our cells to avoid infection completely. T-cells work later in the process, attacking the virus once it is inside our cells, limiting its ability to cause severe disease.

Our latest study, published in the Journal Blood Cancer Discovery, shows that blood cancer patients can have varying responses to COVID-19 vaccination. Some will have both detectable antibodies and activation of their T-cells, while others will have neither. Many blood cancer patients fall somewhere in between: have antibodies but no T-cells, or T-cells but no antibodies. These differences are likely related to the type of blood cancer they have and its treatment, which can affect B-cells, which are responsible for making antibodies, or T-cells.

So, what does all this mean? It means blood cancer patients should get vaccinated but act unvaccinated. Get all vaccine doses as recommended by public health officials—they are safe, and most patients will have at least some benefit—but don’t throw away your mask just yet.

Updated (Bivalent) Vaccine Boosters Are Available Now!

New bivalent booster vaccines are designed to provide broader protection against the viruses that cause COVID-19, including the currently circulating Omicron variant and the original strain. This new booster is recommended for everyone 12 years of age and older.

The Pfizer-BioNTech and Moderna bivalent boosters are interchangeable for adults 18 and older—you can get either one regardless of which brand you received earlier. But only Pfizer-BioNTech is approved for children 12 to 17 years of age. For now, the original (monovalent) booster is the only one recommended for children younger than 12, but CDC expects to move them to the new bivalent booster soon.

The bivalent booster should be given at least two months after completing the primary vaccination series or receiving the most recent booster shot, or 4-months after a recent Covid-19 infection.

LLS encourages blood cancer patients to get the new bivalent booster as soon as they are eligible.

Is It Time for Your Next Dose of Evusheld?

The monoclonal antibody Evusheld is recommended every six months for blood cancer patients and others who are high risk of serious outcomes from COVID-19 and who may not get optimal protection from vaccines.

If it’s time for your next dose, or if you never had one but believe you are at risk, please contact your healthcare team today to inquire about getting Evusheld.

Evusheld is an infusion of “ready-made” antibodies that are given by injection. They provide at least some immediate protection compared to vaccines, which take a few weeks to work, but they only last a short time, which is why you need them every six months.

Please remember that if you have a weakened immune system because of your cancer or its treatment, you should continue taking other precautions, like masking and social distancing, when possible, even if you are fully vaccinated and have taken Evusheld.

You Are Invited to Hear Directly from LLS and Other Experts

Join us on Thursday, October 20 as we bring together a panel of experts for an update on what we are learning about COVID and blood cancer patients, including data on infections and reinfections across blood cancer types and the effectiveness of Evusheld and COVID-19 vaccines.

Click here to learn more and register for this free event happening on Thursday, October 20 at 1:00 pm Eastern/10:00 am Pacific time. tlls.zoom.us/webinar/regist...

LLS Information Specialists Are Just a Phone Call Away

You can reach LLS Information Specialists by phone, email or even live chat for up-to-date disease, treatment and support information. Their contact information is here. lls.org/support-resources/i...

The U.S. is still experiencing more than 80,000 new COVID infections and about 400 COVID-related deaths every day. These numbers are expected to rise in the fall and winter, making this a critical time to review what you can do to stay safe.

Sincerely,

Larry Saltzman, MD

Executive Research Director, LLS National Patient Registry

Lee Greenberger, PhD

LLS Chief Scientific Officer

[SeymourB]

lankisterguy -

I have mixed feelings about this study and this paper, which has been a long time coming. I am part of the LLS Registry, and continue to do spike IgG testing through LabCorp even though LLS no longer does such testing, despite having gotten Evusheld and a COVID infection. I'm just a curious guy, and I don't think that spike antibody testing has much predictive value at this point.

By now, some of us have indeed gotten symptomatic infections, despite multiple vaccinations and Evusheld. So the qualitative T-cell results in this paper are of dubious benefit. I was positive on a T-Detect test myself (paid for out of pocket), and did indeed get a symptomatic infection that dragged on for several weeks, despite 4 vaccines, Evusheld, and Paxlovid. I am watch and wait, BTW, with hypogammaglobulinemia.

Results from this study reflect older variants. New variants continue to appear. It seems impossible for research to provide timely, useful information at this point in the pandemic. We can only hope to gain theoretical knowledge at this point, I think.

The ImmunoSEQ T-Detect test used in the study only provides qualitative, positive vs. negative info, and not quantitative info that would shed much more light. One cannot infer any degree of protection via T-cells via these results. People who do not respond to a T-Detect test should take extra precautions, I think.

Nevertheless, I think the future of T-cell sequencing is bright, and could answer important questions regarding total immunity. However, unlike antibody testing, T-Detect is a proprietary test from Adaptive Biotechnologies - the same company that offers the ClonoSEQ test for MRD testing for CLL/SLL, BTW.

The paper alludes to other T-cell assays:

"T cell responses in this patient population have mostly been characterized by IFNγ production. "

The footnotes in the paper are excellent reading for my fellow immunology nerds interested in T-cell responses to vaccines, which I regard as the Dark Matter of Immunology:

[11] Antibody and T cell imune responses following mRNA COVID-19 vaccination in patients with cancer

ncbi.nlm.nih.gov/pmc/articl...

[12] COVID-19 vaccines elicit robust cellular immunity and clinical protection in chronic lymphocytic leukemia

ncbi.nlm.nih.gov/pmc/articl...

[13] Cellular and humoral immunogenicity of the mRNA-1273 SARS-CoV-2 vaccine in patients with hematologic malignancies

ncbi.nlm.nih.gov/pmc/articl...

I've yet to digest them all. [11] is from 2021, and has the best T-cell info. [12] concentrates on seroconversion (a qualitative assessment of any antibody response at all), and is likely responsible for so many doctors withholding approval for Evusheld for people who are barely seropositive.

The paper below indicates that CD8 T-cell response was key to some degree of protection against death earlier in the pandemic;

nature.com/articles/s41591-...

CD8+ T cells contribute to survival in patients with COVID-19 and hematologic cancer

The big takeaway is to know that you are vulnerable, and make sure you have access to post-infection therapeutics that still work. Currently, those are Paxlovid, Remdesivir (Veklury), and Bebtelovimab.

=seymour=

[lankisterguy Volunteer in reply to SeymourB]

Hi SeymourB,

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I absolutely agree with you.

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There is so much that the experts do not know about our immune systems. And the evolution of SARS-COV-2 is moving so quickly that every time the researchers find a new variant of COVID-19, the data on hand is obsolete.

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So in most cases, when I go to the Supermarket (7:00am this morning) and walk around my small city in NJ, I am the only one wearing a mask. When no one else is masked I use an N95 with an exhaust valve for my own comfort. When I go where masks are required I switch to the N95 version without the valve- to protect others.

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So I still am following the swiss cheese model (see below), and eating/drinking or sitting outside, upwind from everyone else before I relax my mask. We have a well ventilated sun porch that we use for all visitors to our house. We have 5 guests coming for Rosh Hashanah on Sunday- the largest "crowd" that has been in our house in 2.5 years, and I will be masked most of the time.

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So it's not over, and if I get a positive PCR test, I will be contacting my CLL expert on speed dial, and using whatever antiviral is the best treatment that day.

Despite what the President claims, it ain't over for us immune compromised- that 800 lb gorilla can still kill us.

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Len

The swiss cheese model

[newyork8 in reply to lankisterguy]

It's not over period. 3 vaccinated boosted healthy people in my family just got it. Wishful thinking on Biden's part.

[newyork8]

Thanks for post. The reality is despite Evusheld still be super cautious. I just got Covid after 2 300mg doses of Evusheld. My last 300mg like 2 weeks ago. This Omicron is super spreadable and I don't think prior vaccines do much for even healthy people in terms of prevention. Maybe the new booster is better.