Breakthrough COVID infection in patients with lymphoma may be due to lost vaccine efficacy
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NEW ORLEANS — Breakthrough COVID infection rates in patients with hematologic malignancies did not correlate with anti-spike antibody levels, suggesting mRNA vaccines may have lost efficacy against the omicron strain, according to a study.
In the study presented at ASH Annual Meeting and Exhibition, approximately 10% of patients with hematologic malignancies, including lymphomas, who had two to four vaccines against SARS-CoV-2 reported a breakthrough infection during the omicron surge. The data comes from an analysis of patient reported surveys, conducted between February 2022 and August 2022, presented by Sneha Reddy, MD.
"We found that the breakthrough rate does not vary depending on levels of anti-spike antibodies post vaccination," Reddy, a clinical research fellow at The Leukemia and Lymphoma Society said.
“This suggests that antibodies produced in response to the original forms of the vaccine have lost efficacy against the omicron strain of SARS-CoV-2. These results are consistent with the loss of neutralizing ability of anti-spike antibodies produced in response to mRNA vaccines directed to the original COVID-19 strains to block infections in laboratory studies,” she continued.
Reddy noted that in some patients, rapid decay of anti-spike levels after their third vaccination may be contributing to breakthrough infections.
Breakthrough infections surged between December 2021 and January 2022, Reddy said during the poster presentation. This surge in omicron infections correlated with a surge in the general population, Reddy said.
Of the patients surveyed, 2,691 had hematologic diseases, with most patients (27%) reporting a diagnosis of lymphocytic leukemia. Other malignancies included multiple myeloma, Waldenström's macroglobulinemia, follicular lymphoma, diffuse large B-cell lymphoma, non-Hodgkin lymphoma and others.
Analysis of 872 blood cancer patients showed a total of 83 patients who reported a breakthrough infection.
Researchers noted limitations to the study, including that patients’ social patterns could also be a factor in breakthrough infections.
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Reddy S, et al. Poster 2300. Presented at: ASH Annual Meeting and Exposition; Dec. 10-13, 2022; New Orleans.
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