New Study: COVID-19 Breakthrough Cases Can Be A Serious Threat to Blood Cancer Patients, Including Me

As a journalist and three-time survivor of stage IV non-Hodgkin's lymphoma who is "immunocompromised," according to my oncologist, I've been reporting on the heightened threat that Covid-19 poses for lymphoma patients with great interest, and admittedly some anxiety.

As they say, denial ain't just a river in Egypt. I can neither run nor hide from the fact that there are now multiple studies worldwide showing that people with lymphoma and other blood cancers are at a substantially higher risk than healthy individuals for severe and life-threatening COVID-19 illness, and research suggests that lymphoma patients don't always achieve optimal protection from vaccination. 

A new American Society of Hematology Blood study, the first to report on post-vaccination COVID-19 cases in patients with blood cancer, offers preliminary findings about the incidence of so-called "breakthrough infection" among my fellow blood cancer patients. 

Breakthrough infection refers to people who are fully vaccinated but still get Covid-19.

The study drew data from an open online registry, EPICOVIDEHA, which collects reports of patients with blood cancers who developed COVID-19 infection. 

As of August 31, out of the 4,000 total cases in the registry, there were 113 reported cases of COVID-19 occurring after vaccination. 

More than three out of four of these breakthrough cases occurred in patients who were fully vaccinated with either the AstraZeneca vaccine or the mRNA vaccines such as Moderna or Pfizer. 

Approximately 23% had been partially vaccinated, receiving just one dose of an mRNA vaccine, when they became infected with COVID-19. 

Within the group of breakthrough cases, 79 patients experienced severe or critical COVID-19 infection, with 75 needing to be hospitalized. 

After a follow-up of 30 days post-COVID-19 diagnosis, 14 (12.4%) patients died, and COVID-19 was deemed the cause of death for all but one of those individuals. 

The study researchers emphasize that although the mortality rate in patients with breakthrough COVID-19 cases was high, it was still much lower than before vaccines were available. 

In an interview with The Reno Dispatch, study author Livio Pagano (right), MD, of the Università Cattolica del Sacro Cuore in Italy, told me, “Vaccines have significantly lowered the overall mortality rate in our patients with hematologic malignancies. Still, some patients are not showing a full protective response from vaccination, so it is important that we understand which patients are more susceptible to breakthrough infection so we can investigate how to protect them.”

This gives me some comfort, if not a lot. 

As for why lymphomas are harder hit by COVID-19 breakthrough cases, Pagano explained, “The majority of patients who do not respond to vaccination are those with lympho-proliferative disease such as lymphomas and multiple myeloma."

Pagano said these patients are often immunocompromised due to altered functionality of lymphocytes -- both from the underlying malignancy and the chemo-immune treatments -- so they do not always receive optimal protection from the vaccines.

"These patients appear to be more vulnerable to breakthrough COVID-19 infection," he said. "Patients with lymphomas are advised, even after getting the vaccine, to continue supportive measures such as wearing masks, washing hands, and reducing physical contact with other people.”

Previous studies using the registry’s data reported that during the pre-vaccination period of the pandemic, people with blood cancers and COVID-19 had mortality rates ranging from 30% to 50% (depending on type of underlying blood cancer).

“Before vaccination, if our patients with hematologic malignancies [blood cancers] developed COVID-19, they died in a lot of cases,” Pagano said in a press statement. 

“With these preliminary data, we showed that vaccination is not able to completely protect, but surely it has a strong role in reducing the mortality for COVID-19 for people with blood cancers.”

The study also found that the level of COVID-19 vaccine response was associated with the type of underlying blood cancer. 

People with myeloproliferative disorders (disorders of red blood cells and platelets) were the least likely to develop COVID-19 after vaccination, and people with lymphoproliferative disorders (disorders of lymphocytes, the white blood cells of the immune system) were the most likely. 

Of the 113 breakthrough COVID-19 cases, 80% occurred in people with lymphoproliferative conditions such as chronic lymphocytic leukemia, non-Hodgkin's lymphoma, Hodgkin's lymphoma, and multiple myeloma.

“Unfortunately, people with lymphomas are more likely to have suppressed immune systems and to develop infections, and it is no different for COVID-19,” said Dr. Pagano. 

“In future studies we will look at the efficacy of additional vaccine doses to understand if they can reduce infection in our patients, especially those with lymphoproliferative disorders.”

The type of COVID-19 vaccine did not affect the risk of breakthrough cases. 

Approximately 70% of the patients in this study received an mRNA vaccine such as the Moderna or Pfizer vaccine, and the remaining patients received the AstraZeneca vector-based vaccine or the Sinovac inactivated vaccine. 

There was no significant difference in the prevention of COVID-19 between these two groups.

“The key message is that we must make a great effort to vaccinate as many people as we can,” said Pagano. 

“We can’t only vaccinate our patients with hematologic malignancies; it is also important to vaccinate their caregivers so we can form a barrier of protection around them, because their own immunity from the vaccine is not enough.”

These are important facts that we all deserve and need to know. But they are sometimes hard for me to read and even harder to acknowledge. 

Good Friday! Joe Biden's Best Day In Office

Despite the fact that it's early November, yesterday must have felt like Good Friday for President Joe Biden. Our allegedly sleepy President was wide awake and enjoying easily his best day in office. 

Among the gifts in Biden’s seven-month late Easter basket: An excellent jobs report that left Republicans mumbling, and the overdue passage of a historic $1 trillion piece of legislation that will provide hundreds of billions to fix our roads, bridges, pipes, green energy and more, and create many jobs. His predecessor of course never got that done.

In addition, Biden’s sweeping $1.75 trillion social-spending and climate bill passed a procedural hurdle in the House and it looks like this, too, shall pass if the lefties in the democratic party stick to their word. 

Biden also announced on Friday that the U.S. economy created more than 500,000 jobs in October, far more than expected, and that unemployment dropped to 4.6 percent, it's lowest mark since May 2020 during the early days of the pandemic. 

Meanwhile, Pfizer announced on Friday that in clinical trials, its antiviral pill showed nearly 90% effectiveness rate in reducing hospitalizations and deaths from Covid. This should have a profoundly positive impact on the pandemic and global health.

Meanwhile, Biden this past week also brought the U.S. back to the global table on climate change and acknowledged that it is of course real. 

There are still problems in this economy. The supply chain issue remains a major headache, as do high gas prices, college tuition costs and jobs for minorities and women. But this past week saw far more good news than bad for the economy and for our country.

And Biden's just beginning. As Yahoo News reported yesterday, Biden and members of Congress are working out the specifics of a multi-billion dollar agreement with Black farmers as part of the Build Back Better (BBB) infrastructure spending plan.

The farmers, nearly 50,00o strong, were a big reason why Biden did so well last year in southern states that are typically red. 

What was perhaps lost in Biden's good day is the fact that the bull-market recovery from the pandemic continues. The Dow Jones soared to above 36,000 points for the first time ever. 

When you look a little closer at the increase, a percentage rise of just 2.9 percent, it may not look quite as impressive. But given where this economy and this country was, it is even more reason for optimism. 

Lest we all forget, and I think many of us have, Joe Biden was elected in a time of almost unprecedented political chaos. The former presidency's time in office was defined by daily lies.

And the former president's loyal, lawless supporters violently and despicably attempted to throw out the results of an election in which there was simply no evidence of widespread voter fraud.

Biden won a year ago. Bigly. And the results are completely legitimate. But many on the losing side still insist the election was stolen. It wasn’t. 

Biden entered the White House at a time in which the American presidency itself had lost all standing worldwide. Biden has only begun to tend to the wounds the previous administration caused to our democracy.  

Have some of you really forgotten what Biden inherited? It was a bloody mess. We all had to endure a pandemic as well as a political scandal that dwarfed Watergate. 

Globally, the former president alienated virtually every American ally, and kissed up to and praised dictators.

While Biden is certainly not perfect, he is a good man and he is cleaning up the mess. He has re-engaged our allies. And slowly but steadily, Biden is bringing honor and decency back to the White House. 

And now, finally, his policies and plans are beginning to positively emerge. 

Historic China Lymphoma Project Is About to Take Flight

Lymphoma expert Dr. Jonathan Schatz (left), myself, and cancer researcher Dr. Zhizhong Li

It was just a little idea I had about a decade ago. But I am determined now to move move our China Lymphoma Project forward. Our first global conference, which took place several years ago at the Sanford Consortium for Regenerative Medicine in La Jolla, Calif. (above), was a terrific beginning. 

It was a lively, informative and inspirational event whose overriding theme was the friendship between scientists in China and scientists in the United States. The people of the two most powerful countries in the world have an enormous opportunity to move forward together through science. There were not many folks who thought we could pull this off. 

My original speech was widely embraced. And now I have returned to this project that I had to postpone.

 

I never listen to doubters. 

As we in the United States looked for ways to address the cancer crisis in China, where I have many friends and colleagues and where more than 7,500 people die of the disease each day, the consensus among many who attended the conference was that our little project was a positive thing that has the potential to make a real difference.  

While putting this project together, we worked side-by-side with such prestigious young biopharmaceutical companies in China as JW Therapeutics, InnoCare Pharma, and AntiCancer Bioscience.

Each of these companies has a game-changing lymphoma treatment approved for use and/or in clinical trials. And each of these companies has a presence in both China and the United States.  

 

And that is the key point here. These companies are involved in bringing new, state-of-the-art cancer treatments to both China and the United States.  And there are multiple United States companies that have a presence now in China.

 

Cancer knows of no boundaries. And lymphoma, especially, is a worldwide menace. As many of you know, I've been fighting lymphoma and writing about it for 25 years. My cancer recurred a few months ago after a 20-year plus remission, and I just recently saved my by choosing to go through CAR T immunotherapy. 

 

In China, lymphoma has been on the rise for the last decade. And it is already the fifth most common cancer in the US. 

Lymphoma is of course one of several types of cancer that is alarmingly on the rise in China, especially in urban areas where there are hazardous levels of pollution. 

But unlike lung cancer and some other cancers, lymphoma remained a great mystery to many people in China -- despite the fact that it was becoming much more common.

That has changed, as I predicted it would. China is now enjoying a biotech boom, especially with regard to blood cancer awareness and treatments and clinical trials, largely thanks to the companies I named above.

The government in China, too, is making a concerted effort to address the problem by, among other things, "declaring war" on air and water pollution, and of course by supporting the biotech industry's growth. 

 

There are a number of biotech companies in China that are now researching and marketing new lymphoma treatments, and the greatest thing about this boom is that it has generated several new partnerships between China and the US.

This remains a great and mostly untold story. US and China pharmaceutical companies are now partnering on projects and research. And this can only lead to positive things for the planet. 

The conference I held several years ago powerfully represented our project's mission, which was and is to bring our countries closer together under the banner of science. Our goal has not changed.

The idea is to leverage the latest communication technologies (social media, podcasts, smartphone apps and more) to provide much-needed information and hope, as well as comfort and compassion, to China's lymphoma cancer sufferers and their families and increase good will between our two great countries. 

When I started this, many people in China who received a lymphoma diagnosis just went home and gave up. The awareness of this type of cancer was just not widespread. Many believed it was a death sentence.

With access to new information about treatments and stories of Chinese people as well as others around the world who have been treated and are now doing fine, that has all changed. They now know that all types of lymphoma are treatable and beatable. 

A Global Gathering in La Jolla

Dr. Jonathan Schatz, a globally respected lymphoma physician and researcher from Sylvester Comprehensive Cancer Center at the University of Miami, pledged his and the hospital's support for the project, talked at our first conference about the need for more international cooperation between physicians, and suggested the project should pursue more epidemiological studies on lymphoma in China.

We are now moving moving closer to publishing our exclusive new e-book for China's lymphoma patients that profiles survivor stories, including famous China lymphoma survivors such as Kai-Fu Lee, the hugely popular micro-blogger and creator of Google China, as well as just regular folks (men, women and children) throughout China. 

This ebook will of course be FREE to China's lymphoma patients, and will be of course available in both Simplified Chinese and English.

Project Reaches Tipping Point

Our project now resonates with an increasingly broad audience worldwide. With all the social media, etc., it makes more sense than ever. We now expect this positive initiative to fly after a few starts and stops. 

 

As I told the gathering at my conference introduction back in 2016, the biotech and cancer hospital communities in both China and the US are eager to join us. Because everybody wins. 

The booming San Diego tech community is coming to us now, too, as are a variety of healthcare companies, doctors and more. And pretty much any science-focused company doing business in China or would like to and anyone who cares about China's people and about goodwill between the two most powerful countries in the world. We have positive and substantive relationships with several American universities, biotech leaders from China and the US, and more.

Support From Chinese Government Officials

Hua Liu, Consul of Science & Technology, Photos by Caitlin Prenga

Perhaps most importantly, there were also three representatives at that original conference from the Chinese Consulate General in Los Angeles, including our distinguished opening speaker Hua Liu (left), who at the time was Consul in Science and Technology. Members of the Consulate General's office warmly pledged their support. We look forward to working closely with them.

Other speakers at the conference included Dr. Huan-You Wang, a highly respected pathologist and lymphoma diagnostic expert at UCSD Moores Cancer Center, my personal cancer hospital. 

 

Dr. Wang stressed the need for all cancer patients to get the correct diagnosis, and noted that while there are many brilliant doctors and scientists in China, diagnosing cancer in China still has a long way to go. 

Typically, he said, pathologists in China were not specialists, they covered all diagnoses, not specific types of cancer. This, too, is changing as more hospitals learn about blood cancers and have access to new treatments and clinical trials. 

Dr. Catriona Jamieson, the acclaimed physician and expert in lymphoma and other blood cancers and Director of Stem Cell Research at the UCSD Moores Cancer Center, spoke brilliantly yet conversationally at our initial launch about the groundbreaking efforts at Moores to identify new ways to treat cancer, including lymphoma. 

She also explained a few of the encouragingly growing number of partnerships between cancer scientists in China and the US. This has increased many-fold since her speech, as she predicted it would.

Yours truly (left) and Dr. Jinghong Li

The final speaker was Dr. Jinghong Li (left),  an esteemed physician who trained at Peking University Health Science Center, Beijing. Jinghong gave a charming and informed talk about her work with cancer patients and others and expressed her deep gratitude and support for the project.

Please Support This Global Friendship Initiative

Let's get back on the horse. The China Lymphoma Project is seeking funding to fulfill our global mission of friendship through advanced science. Please support this historic project with a tax-deductible educational grant.

E-mail us at: sdsufan2000@gmail.com 

My cell is 858-397-4950

 

Xie-xie,

 

Jamie Reno
Founder and Director
The China Lymphoma Project