Ask the Doctor: If a patient receives a daily treatment of ibrutinib, will it be beneficial to stop the treatment for a week after receiving the vaccine in order to allow for the immune system to generate antibodies more effectively?

Question:

If a patient receives a daily treatment of ibrutinib, will it be beneficial to stop the treatment for a week after receiving the vaccine in order to allow for the immune system to generate antibodies more effectively?

Answer: Unfortunately, there are no data on this at this time. Dr. John Byrd wrote a great opinion piece and touched on this topic in point number two. You can read that opinion piece in its entirety here:

• https://cllsociety.org/2021/05/monitoring-vaccination-effectiveness-for-preventing-sars-cov-2-infection-and-covid-19-syndrome-in-cll-a-data-poor-but-opinion-rich-discussion/

Here is Dr. Byrd’s response: “We do not know the answer to this. In general, I recommend patients get the COVID-19 vaccine as soon as possible. I also do not stop therapy for CLL to administer the vaccine. This is particularly true for BTKi where discontinuation may result in a tumor flare (painful enlargement of lymph nodes). While it is true that BTKi such as ibrutinib and acalabrutinib may decrease the vaccine response, they also reverse immune suppression which may increase the ability of CLL patients to gain some benefit to the vaccine. Until a rigorous study can be done, we will not know the answer to this question. Also, it should be noted that we have observed patients on long-term ibrutinib or acalabrutinib that have had robust antibody responses to the COVID-19 vaccines.”

Please discuss this question with your CLL physician, and if you have not already done so, please get vaccinated. Some immunity is better than no immunity.