Issues

Blood cancer patients are among the most vulnerable to COVID-19 infection. In this issue, two clinical studies from Memorial Sloan Kettering Cancer Center show they may also be among the least protected by the vaccines. On page 568, Chung et al. report low antibody titers and even lower neutralizing activity among 551 patients with leukemia, lymphoma, and myeloma as compared to healthy controls. Venetoclax, kinase inhibitors, and B-cell antigen–targeting therapies further cripple vaccine-elicited immunity. On page 577, Tamari et al. show that immune recovery after cellular therapies of hematologic cancers correlates with response to COVID-19 vaccines. In a pooled data analysis of these and other studies, Ribas et al. (page 562) conclude that hematologic cancer patients have impaired antibody response to vaccination and boosters, and call for public health measures to protect this vulnerable group. Among the recommendations is to give booster vaccine doses to patient’s caregivers and household members. The cover image illustrates how this strategy can prevent viral spread to and from patients with blood cancer. Artwork by Katie Vicari.