How Does CLL Treatment Impact the Ability to Fight COVID?

Experts responded to listener questions during our January 13, 2023 virtual town hall. Watch the full webinar here.

Jeff:    

Dr. Jain, this is a great question that came in from Irv. How does being treated for CLL affect a person’s ability to fight COVID?

Dr. Jain:          

Well, I mean, I think that at the end of the day it’s your immune system which plays a major part in our ability to fight COVID, or for that matter any other infections we are dealing with. So patients who have relapsed CLL or patients who had prior therapy for CLL, and depending on which therapy they have received – and if they received chemoimmunotherapy, which again is only becoming less and less as a choice for patients to use. Patients can get low blood counts and things like that, which can certainly influence on getting higher severity of COVID if their immunoglobin is low.

At the same time as we were just discussing, patients who are on active treatment for their CLL or who have had multiple therapies for their CLL, including maybe ibrutinib (Imbruvica) or venetoclax (Venclexta) – many times only their immunoglobins may be low, their hemoglobin which are in the blood. And we know that patients with CLL – who have long-standing CLL – though they may have normal T-cell lumbar, their T cells don’t function very properly. So, their immune cells are dysfunctional.

If you get COVID in that situation where your immune cells are dysfunctional, maybe your neutrophil count is on the low side, maybe your immunoglobin levels are on the low side, so there might be multiple aspects of immune system is not working properly, you are more likely to get a more severe aspect of COVID if you were to catch COVID. So, I think, for patients with CLL, I think it is especially an important aspect, especially because, as we discussed, we know the common therapies for patients with CLL, at least in the past we know with vaccinations they were not responding to vaccinations as well.

So, I think we have seen some tough, aggressive forms of COVID, or patients requiring ICU and things like that when they develop COVID, and they have multiple relapsing/refractory CLL.