Ongoing anticancer treatment dulls immune response against COVID-19

Therapy-naïve patients with haematological malignancies (HM) are able to mount a stronger immune response to the coronavirus disease 2019 (COVID-19), a recent study has found.

Researchers conducted a cross-sectional analysis of 189 HM patients (median age 62.6 years, 63.0 percent men) with lab-confirmed SARS-CoV-2 infection, of whom 71 were receiving anticancer treatment at the time of infection. Overall, 85.7 percent (n=162) of patients were positive for seroconversion for both the anti-receptor binding domain and anti-spike immunoglobulin G.

Notably, seroconversion was lower among patients who were receiving anticancer therapies than those who were not (74.1 percent vs 84.1 percent).

In particular, of the 13 patients exposed to B-cell/plasma cell-depleting monoclonal antibodies during their infection, five (38.4 percent) did not seroconvert. The same was true for 25 percent of the 44 patients who had undergone haematopoietic stem cell treatment.

Cancer status likewise affected the likelihood of conversion. Those with stable/progressive disease saw a seroconversion rate of 69.7 percent, as opposed to 94.9 percent in patients who were in the “watch-and-wait” group.

“Although our findings confirm the reduced seroconversion in HM patients, especially those with lymphoid disorders or undergoing chemotherapy-based treatment during SARS-CoV-2 infection, the overall neutralizing humoral response upon natural SARS-CoV-2 infection seems to be quite efficient and sustained overtime, with a consistently more robust response in ‘watch and wait’ patients,” the researchers said.

“More efforts should be put in place in order to develop tailored vaccine approaches (eg, boosters or heterologous vaccination) to thoroughly assess the humoral response, and to ensure the effectiveness of SARS-CoV-2 vaccination in this unique population of patients,” they added.