Patients with hematologic malignancies varied in their immune response to COVID-19, and some struggled to clear the infection, according to new research published by Abdul-Jawad in Cancer Cell. In contrast, most patients with solid tumors—even those with advanced cancer—were shown to be able to mount an effective and lasting immune defense against the virus.
Researchers from King’s College London and the Francis Crick Institute have been studying the way SARS-CoV-2 impacts the immune system through the COVID-IP project, and have already identified immune signatures that are associated with severe disease and hospitalization. Their latest collaboration, called SOAP, is specifically investigating whether patients with cancer have a different response to the coronavirus vs the general population, and if these patients experience any long-term effects from infection.
Immune Response Differences
The research team analyzed the blood of 76 patients with cancer: 41 who had COVID-19 and 35 who had not been exposed to the virus. Twenty-three patients had a solid tumor, and 18 had a hematologic malignancy.
When scientists compared samples with the immune signatures from patients who had been infected with COVID-19 who did not also have cancer, they saw that patients with solid tumors had a similar immune response to those without cancer—regardless of cancer stage or if they were undergoing treatment. These patients were still able to mount an effective and lasting antibody response.
However, the immune response of patients with blood cancers varied considerably, particularly for patients with cancers that affect B cells, which are crucial for mounting an antibody defense. In most, the response to infection was less pronounced and took longer to develop. Some patients struggled to clear the infection, and others developed no antibodies at all, meaning that certain patients with blood cancer had an active coronavirus infection for more than 10 weeks.
Sheeba Irshad, MD, PhD
Sheeba Irshad, MD, PhD, SOAP project lead at King’s College London, said, “Whilst we need to maintain caution, our study provides some confidence and reassurance to care providers that many of our patients with solid cancers will mount a good immune response against the virus, develop antibodies that last, and hopefully resume their cancer treatment as soon as possible.”
She continued: “These conclusions imply that many patients despite being on immunosuppressive therapies will respond satisfactorily to COVID-19 vaccines. For patients with blood cancers, especially those with B-cell malignancies, this may not hold true even in the era of COVID-19 vaccines. Our work suggests that they may be susceptible to persistent infection despite developing antibodies, so the next [and ongoing] stage of our study will focus on monitoring their response to the vaccines. At present, the best way to protect them may be to vaccinate all [health-care providers] to achieve herd immunity in the clinic.”
The next phase of the SOAP study will be monitoring the immune responses of patients with cancer to the COVID-19 vaccine.
Disclosure: For full disclosures of the study authors, visit cell.com.
