Tag Archive for: flu

CLL and Vaccines | Vital Advice for Protecting Patients

CLL and Vaccines | Vital Advice for Protecting Patients from Patient Empowerment Network on Vimeo.

 What do chronic lymphocytic leukemia (CLL) patients need to know about vaccines? Expert Dr. Ryan Jacobs explains CLL treatments that reduce vaccine response and his vaccine recommendations.

Dr. Ryan Jacobs is a hematologist/oncologist specializing in Chronic Lymphocytic Leukemia from Levine Cancer Institute. Learn more about Dr. Jacobs.

Download Resource Guide   |  Descargar Guía en Español

See More from START HERE CLL

Related Programs:

How Can I Ensure My CLL Doesn't Progress to Richter's Transformation?

How Can I Ensure My CLL Doesn’t Progress to Richter’s Transformation?

CLL and BTK Inhibitor Treatment: What Are the Risk Factors?

CLL Genetic Markers: What Should I Ask About Prognostic Factors?

CLL Genetic Markers: What Should I Ask About Prognostic Factors?


Transcript:

Lisa Hatfield:

So we have another patient who has asked a series of questions. Her first question is, “Can you speak to immune vulnerability and the importance of regular vaccination for CLL patients?”

Dr. Ryan Jacobs:

Yes. So we know that having active CLL reduces a patient’s ability to respond to vaccination and increases redirection, we know being on treatment for CLL also produces varying risk depending on the treatment. The drugs that seem to do the most damage to the immune system, and specifically in terms of their ability to respond to vaccination or the antibody treatment like rituximab (Rituxan) and obinutuzumab (Gazyva), and their effects last for many months after that treatment is finished. Unlike the oral drugs which have a short half-life, the antibodies hang around for many months after being administered.

I in general am recommending, as does the CDC, to get boosted every six months for patients with any level of immune suppression and having CLL qualifies you as that. And then I recommend all of the general vaccines that come with age, like, for example, the Shingrix vaccine for shingles is now safe to give to CLL patients because it’s a conjugate vaccine, it’s not a live virus vaccine.

So we’re lucky now with just standard vaccines in the U.S., there are no live virus vaccines that the CLL patient has to worry about anymore, so I definitely encourage shingles, pneumonia vaccines, boosting for COVID. We’ll see if we get an RSV vaccine, that sounds like it’s on the horizon. Flu, of course. And the patient should just be aware based on what kind of treatment that they’re on, they may not have a good chance at responding to these vaccines, but I still try with my patients. The other important element to think about when you’re considering an infection risk and everything is just kind of what’s…obviously, the pandemic has been a very dynamic thing, and certain times there’s been a lot more risk than others. Thankfully, at the time of this recording, we’re doing on probably as good as we’ve done since the onset of COVID. So you have to make your decisions on the situations you put yourself into, based on your personal situation and what’s going on in the bigger picture, risk-wise. Flu season, COVID season, a lot of RSV going around or something like that.


Share Your Feedback

Create your own user feedback survey

Immunotherapy: Which Myeloma Patients Is It Right For?

Immunotherapy: Which Myeloma Patients Is It Right For? from Patient Empowerment Network on Vimeo.

Dr. Krina Patel, a myeloma specialist and researcher, explains how newer therapies, such as CAR T-cell therapy, are being used in myeloma and which patients these treatments are most appropriate for.

Dr. Krina Patel is an Associate Professor in the Department of Lymphoma/Myeloma at The University of Texas MD Anderson Cancer Center in Houston, Texas. Dr. Patel is involved in research and cares for patients with multiple myeloma. Learn more about Dr. Patel, here.

Related Resources:

How Does Immunotherapy Treat Myeloma?

What Are the Side Effects of Myeloma Immunotherapy?

Myeloma Treatment & Research Updates From 2022 ASCO and EHA Meetings

Transcript:

Katherine:   

Now, in reference to immunotherapy and CAR T-cell therapy, who are these types of treatments right for?

Dr. Patel:    

So, I think it’s really exciting that we finally are getting standard of care therapies for all these new immune therapies. So, our first CAR T for myeloma got approved a little over a year ago. Our second CAR T got approved just a couple of months ago, and we’re hoping our first bispecific will be approved in just a couple months.

Our fingers crossed. On the clinical trials, I will say our patients who had a good performance status, meaning they’re able to do everything else normally life-wise, those are the patients that got onto those clinical trials; and the reason is safety-wise.

So, T cells when we use them to kill myeloma, they release cytokines or enzymes, you can say, that are inside the T cells and that’s what they use to communicate with other immune cells to come help them kill.

Those are the same cytokines that make people feel really ill when they have the flu, for instance. So, as our immune system tries to fight infections when people get fevers, they feel chills, they feel just fatigued and tired, it’s those same kind of cytokines that, even when you try to kill the myeloma with T cells, people can get that same type of symptoms.

And really, the main, fevers and things like that, we can take care of. But when patients’ blood pressure drops or if their oxygen levels drop really low, that’s where we can run into some trouble. Now, the good news is, in myeloma, most of these new therapies don’t cause really bad CRS [Cytokine Release Syndrome] or really bad neurotoxicity that we can sometimes see. And so, thankfully most patients are okay, but really it’s making sure that none of our patients have bad toxicity. So, most of our myeloma patients, I will say, are eligible for these therapies. However, if someone has really bad heart disease or really bad lung disease, those are patients that maybe these are not the right therapies for.