On this section you will find statements, expert talks and frequently asked questions about COVID-19 vaccines and CML.

1. 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

Other useful statements on COVID-19 vaccines:

• EHA (European Hematology Association) for the Scientific Working Group Infections in Hematology:
  Expert opinions for COVID-19 vaccines in patients with hematologic cancer
• ASH (American Society of Hematology):
  General principles of COVID-19 vaccines for immunocompromised patients (last updated: August 2021)
• CDC (Centers for Disease Control and Prevention): Information on COVID-19 vaccines
• WHO (World Health Organization): Information on COVID-19 vaccines

Please also find links to statements on COVID-19 vaccines for people with CML in other languages:
(last updated January 2021)

• Statement in French
• Statement in German
• Statement in Portuguese
• Statement in Russian
• Statement in Spanish

2. iCMLf Conversations on COVID-19 vaccines and CML

The iCMLf hosted an expert talk on COVID-19 vaccines and CML: (April 2021)

• Overview of different types of COVID-19 vaccines currently in use around the world
  Professor Steve Wesselingh, an Infectious Disease physician and researcher in Neurobiology, HIV and vaccine development, Adelaide (Australia)
  
  
• Current experience with COVID-19 vaccines in patients with CML and guidance on how to best manage patients with CML
  Dr Kendra Sweet, hematologist from Tampa (USA)

View the iCMLf Conversation on COVID-19 vacccines and CML here

3. Frequently asked questions on COVID-19 vaccines

• CDC (Centers for Disease Control and Prevention): FAQs on COVID-19 vaccination (last updated February 2022)
  
• WHO (World Health Organization): FAQs on COVID-19 vaccines (last updated January 2022)
  
• Leukemia & Lymphoma Society: FAQ on COVID-19 vaccines for patients with blood cancer (last updated February 2022)
  
• Leukemia Foundation Australia: FAQ on COVID-19 vaccines for patients with blood cancer (last updated February 2022)
  
  

4. Clinical Case discussion related to COVID-19 vaccines

Physicians can post specific patient cases related to COVID-19 and CML for advice and discussion on the iCMLf Clinical Case Discussion Forum.

Discussions related to COVID-19 vaccines and CML can be found here:

• COVID vaccine for CML patients?