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Questions about CML management during the COVID-19 pandemic remain highly relevant for clinical practice. In particular, whether COVID-19 vaccines are recommended and effective for people with CML.

To provide you with the best possible support, the iCMLf continues to update our COVID-19 Hub with CML specific information on COVID-19. We are also sharing an updated statement on COVID-19 vaccines for people with CML. You can read the full statement below

Updated statement on COVID-19 vaccines for people with CML

'At this time, based on best available information, patients with chronic myeloid leukemia (CML) are encouraged to receive vaccines against COVID-19. While rare special circumstances may exist, most patients, whether early in treatment, in ongoing response, in deep remission, or off therapy having pursued ‘treatment free remission’ are likely appropriate and should pursue vaccination when available to them. Boosters and subsequent doses of the vaccines are also strongly recommended following local health authorities guidelines and availability.

Given the consensus and data that CML and TKI-based treatment present little impact on the immune system, despite being blood cancer patients on therapy, immediate or earlier additional vaccine doses after initial series or dose may not be as urgently needed. Rare circumstances and comorbidities, evidence of low or absent vaccine-derived antibody levels, and patient preference may drive early additional vaccination and discussion with the health care team is essential to guide next steps.i

Based on current findings, neither excess risk of adverse effects, nor concern over effectiveness have been reported for CML patients. ii,iii,iv,v Different vaccine strategies, including the novel mRNA vaccines from Pfizer-BioNTech and Moderna, the vector vaccines from Oxford/AstraZeneca and Janssen, along with the protein-based Novavax vaccine appear safe and effective and no preference is noted at this time.

Since other health conditions and individual medical histories (including reactions to prior vaccinations) may affect advice, suitability, and timing, discussion with a patient's entire health care team is recommended prior to vaccination. Other vaccines, including the Sputnik V, Sinopharm/BIBP, Sinovac and others are approved by local authorities and available in some countries. There is less information available for these vaccines and thus their safety and efficacy cannot be considered fully evaluable.'

Authors: Professor Michael Mauro, Memorial Sloan Kettering Cancer Center, USA and Professor Jorge Cortes, Georgia Cancer Center, USA, in consultation with CML experts

Updated: April 2022

i American Society of Hematology COVID-19 and CML Frequently Asked Questions https://www.hematology.org/covid-19/covid-19-and-cml Accessed 25.03.22

ii. Safety of SARS-CoV-2 vaccines in patients with chronic myeloid leukemia: a multicentre survey in China
Yang et al. Clin Med J (Engl), December 2021 (epub ahead of print) – open access publication

iii Durable humoral responses after the second anti-SARS-CoV-2 vaccine dose in chronic leukemia patients on tyrosine kinase inhibitors
Claudiani S et al. Br J Haematol, December 2021 (epub ahead of print) – open access publication

iv Single dose BNT162b1 mRNA vaccine against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) induces neutralising antibody and polyfunctional T-cell responses in patients with CML
Harrington P et al. Br J Haematol, June 2021 (epub ahead of print) – open access publication

v The 12-week kinetics of anti-SARS-CoV-2 antibodies in different haematological cancers after vaccination with BNT162b2.
Marchesi F et al. Br J Haematol, September 2021 – open access publication