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iwCLL 2025 | Evaluating the safety and efficacy of RSV vaccination in patients with CLL, myeloma, and NHL
Respiratory syncytial virus (RSV) is a common respiratory virus that can cause significant morbidity and mortality in patients with hematological malignancies. In this interview, Yair Herishanu, MD, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, discusses the results of a prospective trial evaluating the safety and efficacy of RSV vaccination in patients with chronic lymphocytic leukemia (CLL), multiple myeloma (MM), and non-Hodgkin lymphoma (NHL). Prof. Herishanu reports that the vaccine was well tolerated; however, low rates of serologic response were observed, particularly in patients treated with anti-CD20 antibodies. This interview took place at the biennial International Workshop on Chronic Lymphocytic Leukemia (iwCLL) 2025 in Krakow, Poland.
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Transcript
RSV infection causes significant morbidity and mortality in older adults and in immune-compromised patients, in particular in patients with hematological malignancies. Recent approved RSV vaccines show high efficacy in older adults, but there is limited data in patients with hematological malignancies. Therefore, we have performed a prospective trial that evaluated the safety and efficacy of RSV vaccination, which is a recombinant RSV perfusion of a protein vaccine in 102 patients with CLL, multiple myeloma, and non-Hodgkin lymphoma...
RSV infection causes significant morbidity and mortality in older adults and in immune-compromised patients, in particular in patients with hematological malignancies. Recent approved RSV vaccines show high efficacy in older adults, but there is limited data in patients with hematological malignancies. Therefore, we have performed a prospective trial that evaluated the safety and efficacy of RSV vaccination, which is a recombinant RSV perfusion of a protein vaccine in 102 patients with CLL, multiple myeloma, and non-Hodgkin lymphoma. We measured anti-RSV IgG levels at the day of vaccination and four to six weeks afterwards, and we correlated the response with demographics and clinical parameters. We also followed after adverse events related to the vaccine.
79 patients were evaluable for response. Their overall response rate was about 28%, which was numerically higher in patients with multiple myeloma compared to CLL and non-Hodgkin lymphoma. And the only statistically significant parameter that correlated with response was exposure to anti-CD20 therapy. Patients that were treated with anti-CD20 antibodies achieved a response rate of only 8% compared to 42% in patients that were not treated with these antibodies. Patients that were treated with anti-CD20 antibodies within 12 months of vaccination, none of them responded. And the response rate in patients that were treated with BTK inhibitor monotherapy was about 43%. Regarding safety, most of the adverse events were grade 1 and local; only a few were grade 2, and no grade 3 and higher adverse events.
In conclusion, RSV vaccination in patients with hematological malignancy is very well tolerated; however, it showed a diminished serologic response, in particular in patients that were treated with anti-CD20 antibodies.
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