Some types of blood cancer can make COVID breakthrough case more severe, study says
People with blood cancers tend to have more severe COVID-19 infections than people without the diseases; they are also less likely to respond to coronavirus vaccines, meaning they are more likely to get infected after vaccination.
Now, new research shows people with blood cancers can have more serious COVID-19 cases after vaccination, too, known as breakthrough cases — and the type of blood cancer makes a difference.
Of 4,000 people with blood cancers enrolled in a European online registry, 113 developed COVID-19 after vaccination. About 77% of them were fully vaccinated, while 23% were partially vaccinated at the time of infection, according to the study’s preliminary findings published Nov. 8 in the journal Blood.
Among those who developed a breakthrough case — infections that occur two or more weeks after complete vaccination — 79 people had a severe or critical coronavirus infection; 75 required hospitalization, and 14 died within a month of their diagnosis.
The study also found some types of cancers weaken responses to COVID-19 vaccines more than others.
Eighty percent of the COVID-19 breakthrough cases occurred in people with lymphoproliferative conditions, which are disorders in the immune system’s white blood cells that fight infections, including chronic lymphocytic leukemia, non-Hodgkin lymphoma, Hodgkin lymphoma and multiple myeloma.
Colin Powell, former secretary of state under President George W. Bush, had been fighting multiple myeloma before COVID-19 took his life on Oct. 18. Powell, 84, was fully vaccinated and awaiting his booster shot.
People with myeloproliferative disorders, which involve red blood cells and platelets, were the least likely to develop COVID-19 after vaccination, the study found.
“Before vaccination, if our patients with hematologic malignancies developed COVID-19, they died in a lot of cases,” study author Dr. Livio Pagano, an associate professor of hematology at the Università Cattolica del Sacro Cuore in Italy, said in a news release. “With these preliminary data, we showed that vaccination is not able to completely protect, but surely it has a strong role in reducing the mortality for COVID-19 for people with blood cancers.”
Extra shots can help people with blood cancers develop COVID-19 protection
Researchers note other studies using the same online registry found people with blood cancers who developed COVID-19 had death rates anywhere between 30% to 50%, depending on the type of cancer they had.
Mounting evidence shows people with blood cancers cannot develop sufficient antibodies after vaccination, but early findings show a third coronavirus shot can help people gain some protection.
Third COVID-19 shots for immunocompromised people are considered an “additional dose,” not a booster.
A study published in September found that among 38 people with B-cell blood cancer, 55% produced antibodies after their third COVID-19 shot after failing to develop antibodies following their first two doses. And the 11 people who did produce antibodies after their initial doses were able to gain more after an additional shot.
“The additional COVID-19 vaccine dose appears to be improving immune response in many people with blood cancer — one of many conditions that can suppress a person’s immune system,” said Dr. Gwen Nichols, chief medical officer at The Leukemia & Lymphoma Society.
“However, while vaccination offers protection to the majority of blood cancer patients, some will not mount a full antibody response even with this additional dose,” Nichols added.
The Centers for Disease Control and Prevention authorized a fourth COVID-19 shot, or booster, for any adult who is moderately to severely immunocompromised (including those with blood cancers) and who received the Pfizer or Moderna vaccine for their initial series, as well as for their third dose, at least six months earlier.
Adults with weakened immune systems who initially received one dose of the Johnson & Johnson vaccine can now get a single booster shot of the J&J, Pfizer or Moderna vaccine at least two months after getting their first dose.
The CDC emphasizes people who got the J&J vaccine should not receive more than two COVID-19 vaccine doses in total.
Experts advise immunocompromised people to continue practicing other COVID-19 preventive measures, such as mask wearing and physical distancing, given their weak responses to the vaccines.
This story was originally published November 11, 2021 at 11:36 AM with the headline "Some types of blood cancer can make COVID breakthrough case more severe, study says."
