ASH 2021 | COVID-19 vaccination in MDS & AML
Patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) are at a high risk of severe COVID-19 infection, and it is currently unknown whether these patients are able to develop a protective immunity from COVID-19 vaccines. Jeffrey Lancet, MD, Moffitt Cancer Center, Tampa, FL, gives an overview of the results of a study investigating the immune response and safety profile of the Moderna COVID-19 vaccine in 30 patients with AML and 16 patients with MDS. One-third of the patients were on active treatment during the course of vaccination. Overall, the study reported that 70% and 95.7% of patients were seropositive after the first and the second vaccine dose, respectively, and antibody titers were significantly higher after the second dose. Variables such as age, gender, race, disease status, time to vaccination from disease diagnosis, number of prior lines of therapy, and whether the patient was on active treatment or had undergone transplantation at time of vaccination were not found to significantly affect the seropositivity rate. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.
Transcript (edited for clarity)
We did a prospective observational study in a large number of cancer patients at our center in early 2020 studying the effect of COVID-19 Moderna vaccine in terms of inducing immune responses in cancer patients. We looked at AML and MDS patients as part of that overall cohort. In this report, we’re looking at the vaccine efficacy amongst AML and MDS patients, recognizing that perhaps these patients might have a lower chance of immune response because of compromises of the white blood count, numbers and function, immunosuppression due to bone marrow transplant, those types of things...
We did a prospective observational study in a large number of cancer patients at our center in early 2020 studying the effect of COVID-19 Moderna vaccine in terms of inducing immune responses in cancer patients. We looked at AML and MDS patients as part of that overall cohort. In this report, we’re looking at the vaccine efficacy amongst AML and MDS patients, recognizing that perhaps these patients might have a lower chance of immune response because of compromises of the white blood count, numbers and function, immunosuppression due to bone marrow transplant, those types of things. What we found was that in this cohort of 46 patients, there was over 95% antibody response rate. In other words, zero conversion rate after the second vaccine dose. This was occurring amongst patients that had factors that you might think would negatively affect the likelihood of an antibody response, things like a low white blood count, being on active treatment, those types of things, post-transplant setting.
We did see a very high overall response rate, humoral response, rate antibody response rate after the second dose of the vaccine. After the first dose of the vaccine, it was lower. It was closer to 70%, but a majority of those patients who were negative also converted to positivity after the second vaccine so I think it indicates the high likelihood of antibody response to the COVID-19 vaccine in this patient population and I think provides evidence that such patients should be actively vaccinated against COVID-19 because they do mount a response. Certainly, we need to learn more about resistance and other factors that may influence response, but the reassuring thing is that most patients did achieve an antibody positive response after the second cycle or after the second dose.
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