This article has been medically reviewed by Dr. Brian Koffman on April 19, 2023.
The Bottom Line:
Approximately 10% of patients with blood cancers who were vaccinated against COVID-19 reported a breakthrough infection during the original Omicron surge. Those with no detectable antibodies or low antibody levels were more likely to be hospitalized for COVID-19 infection.
Who Performed the Research and Where Was it Presented:
Dr. Lee Greenberger from the Leukemia & Lymphoma Society (LLS) and colleagues presented the results at the American Society for Hematology (ASH) Annual Meeting in 2022.
Background:
COVID-19 remains a major concern for many patients with blood cancers, especially those with chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). Many patients with B-cell malignancies like CLL / SLL fail to make anti-spike COVID-19 antibodies, which are the antibodies that block the virus from being able to infect cells. Researchers wanted to understand whether antibody levels as a result of vaccination protected against COVID-19 infection in blood cancer patients.
In this video, Dr. Brian Koffman interviewed Dr. Lee Greenberger, Chief Scientific Officer at LLS. They discussed whether vaccination protects against COVID-19, specifically during the original Omicron variant wave that occurred in late 2021 and continued into early 2022.
Methods and Participants:
This study used data from the Leukemia & Lymphoma Society Registry. Patients were asked if they had been vaccinated against COVID-19, they were asked to report when they received their vaccinations, and whether they had experienced any breakthrough infection(s). As part of being in the registry, patients could get their COVID-19 anti-spike antibody levels measured by a lab and were informed of their results.
Results:
- Approximately 2700 blood cancer patients participated in the registry and were reported to have received COVID-19 vaccinations.
- In total, 295 patients (11%) reported they had experienced breakthrough infections, most of which occurred from December 2021 to February 2022, which coincides with the Omicron surge that happened during that same time in the general US population.
- About 8% of patients who developed breakthrough infections had undetectable levels of COVID-19 anti-spike antibodies after three vaccinations.
- Interestingly, the same proportion of patients (8%) who developed breakthrough infections had very high levels of anti-spike antibodies after three vaccinations.
- This suggests that there might have been behavioral differences. For example, those who knew they had low antibody levels may have stayed home and been extra careful, while those who knew they had high antibody levels may have been more relaxed about taking fewer precautions.
- However, since the SARS-CoV-2 virus has continuously mutated, just because you have antibodies does not equate to complete protection against the most recent dominant circulating variant.
- Nineteen patients who developed breakthrough infections were hospitalized (6%). Of these 19 patients, 7 had zero detectable COVID-19 anti-spike antibodies, and 3 had detectable but low antibody levels.
- This suggests that those with no or low antibody levels are at higher risk for hospitalization when they become infected.
- The Leukemia & Lymphoma Society also did a second similar study (which has not yet been published) looking at whether patients treated with Evusheld developed breakthrough infections around the time of the original Omicron surge. They found that about 12% of patients who had been treated with Evusheld developed breakthrough infections, while about 15% of patients who were not treated with Evusheld developed breakthrough infections.
- These findings are similar to what has been found in other studies showing that Evusheld was not nearly as effective against the newer strains of variants that developed after it initially received FDA emergency use authorization.
Conclusions:
Approximately 10% of patients with blood cancers, who were vaccinated against COVID-19, reported a breakthrough infection during the Omicron surge. The percentage of breakthrough infections was similar regardless of COVID-19 anti-spike antibody levels before the infection. However, those with no detectable antibodies or low antibody levels were more likely to be hospitalized for a COVID-19 infection.
Links and Resources:
Watch the interview on the abstract here:
You can read the actual ASH abstract here: Breakthrough COVID-19 Infections in Patients with Hematologic Malignancies during the Omicron (B.1.1.529) Surge: Data from the Patient-Reported Leukemia & Lymphoma Society National Registry
Take care of yourself first.
Ann Liu, PhD
