Q: Some patients with hematologic cancers have limited response to COVID-19 vaccines. Are there any data being presented that will shed light on vaccine effectiveness in AML patients, and if so, should they change anything about how these patients are advised or treated?
Dr. Sekeres: So, I'm so happy you asked that question. This is a question that I answer every day I'm in clinic, multiple times with my own patients, and we talk a lot. I have some clinic days where I talk more about COVID-19 vaccines than I do about leukemia and myelodysplastic syndromes with my patients. There are a couple of great studies that are being presented at ASH that focus on acute myeloid leukemia and COVID-19. One is from the ASH COVID-19 registry, and I'm a part of that, where we looked at patients who have acute myeloid leukemia, their risks for adverse outcomes when they get a COVID-19 infection, and it really demonstrates that patients who have acute myeloid leukemia who catch COVID-19, the SARS-CoV-2 virus that causes COVID-19, really have terrible outcomes. It is a very scary prospect for somebody with AML to catch COVID-19.
So that provides some evidence on why we need to focus on vaccine strategies and why we are still recommending to AML patients that they maintain precautions amidst Delta variants, and Omicron variants, and anything else that's going to be coming down the pike that could infect them. So there's a study that did come out of Moffitt here in Florida that shows that patients who get double vaccinated for COVID-19 and then have antibody levels measured afterwards, have very high seropositivity of 95%. So, this is consistent with data that was presented by the Leukemia & Lymphoma Society, and it's been published, that shows that patients with myeloid malignancies when they get vaccinated, actually do quite well with generating antibodies to COVID-19. So I recommend to my patients that absolutely they should get vaccinated, double vaxxed and triple vaxxed, because of the seriousness of infection if they do get infected with COVID-19, and that that's safe to do.
Patients with lymphoid malignancies, it's a different story, and the data that came out of Leukemia & Lymphoma Society showed that patients who have lymphoid malignancies have a lower seropositivity rate after getting vaccinated, particularly if they're getting actively treated for those lymphoid malignancies, where the seropositivity rate may actually shrink to only about 20%. So those are patients who are at high risk of getting an infection, of not having the efficacy from a vaccine that we would hope for, and it's certainly an argument for those folks to get booster shots and probably to have their antibody levels assessed after the fact to see if they may need even more vaccine.
Q: Regardless, you would recommend even vaccinated or unvaccinated, all patients with blood cancers, to still follow CDC guidelines regarding wearing masks and social distancing?
Sekeres: Unequivocally 100%. No hesitation in my mind whatsoever. Patients who have hematologic malignancies should get triple vaxxed, because even if it doesn't confer the same protection as it would in somebody who doesn't have a hematologic malignancy, some protection is better than none. So we then continue to counsel our patients to wear masks indoors, practice social distancing, continue to maintain precautions. My God, we are all so exhausted of this, those of us in healthcare, our patients. I feel my patients' pain. This is hard, but we can't let our guard down, particularly in our patients who have hematologic malignancies.
