Wilmot Cancer Institute researchers focused on this hard-to-vaccinate group and how best to prevent this particular illness because people with blood cancers are at higher risk of shingles and its complications, which can be fatal in this population. Shingles is a painful reactivation of the chicken pox (varicella zoster) virus. It is most common in older adults and can cause debilitating rashes and other health problems.
The shingles vaccine is standard care for everyone over age 50. In people with lymphoma, however, doctors have had two concerns about this vaccine in the past: That a weakened immune system due to B-cell blood cancer does not allow a person to make an effective immune response to the vaccine; and that a common treatment for lymphoma, known as BTK inhibitors, might interrupt or prevent an immune response to the vaccine.
According to the Wilmot research published in the journal, Leukemia, 32 lymphoma patients who received a newer version of the shingles vaccine responded favorably. The new vaccine uses an inactivated virus and is safer for people with weakened immune systems.
“This is one of the best vaccine responses anyone has seen in patients with these indolent lymphomas,” said the study’s corresponding author, Clive Zent, M.D., a hematologist at Wilmot. Senior author of the study is Jonathan Friedberg, M.D., director of Wilmot.
The 32 patients with chronic lymphocytic leukemia or lymphoplasmacytic lymphoma were being treated with either ibrutinib or zanabrutinib, drugs within the class of BTK inhibitors. Only 4 of the 32 showed no immune response to the vaccine.
Further studies are needed to confirm the durability of the immune response to the vaccine in patients with lymphoma and poor immune function. Starting in January, Zent said, researchers are planning to check the blood of all patients who participated in the study, to investigate the status of their immune responses two years after their last vaccine.
The research project is dedicated to Carolyne Delage, M.D., a 30-year-old Wilmot fellow specializing in hematology and oncology who was working on the study when she died unexpectedly in 2018 in a bicycling accident in Vermont.