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Q&A on CLL and COVID-19

Q&A on CLL and COVID-19
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Published on March 5, 2021

Nicole Lamanna, MD

Nicole Lamanna, MD

Expert Answers Your Questions on CLL and COVID-19

Last year at this time, life as we knew it was changing rapidly. From schools and businesses closing abruptly, to cancer screenings and treatments being postponed indefinitely, the coronavirus pandemic arrived like an unwelcome guest and settled in for far longer than the original two-week shutdown we all hoped would stop it in its tracks.

From the start of the pandemic, the Patient Power team has been bringing you the latest news and updates on masks, telehealth, cancer drug approvals and more. We’re committed to keeping you informed as new information emerges. In this article, renowned chronic lymphocytic leukemia (CLL) expert Dr. Nicole Lamanna, MD, of the Columbia Herbert Irving Comprehensive Cancer Center answers patient questions about CLL and the COVID-19 vaccine.

CLL and COVID-19

“My [Rituxan] Hycela treatment had to be rescheduled after it conflicted with my second upcoming COVID-19 vaccine. Now my Hycela treatment conflicts with my monthly IVIG that I receive at home. How far apart does my IVIG need to be scheduled after Hycela?” —Loretta P.

 Dr. Lamanna: I am unaware that rituximab really needs to be spaced apart from IVIG. In my practice, I sometimes may not administer them on the same day depending upon someone’s kidney function and/or volume issues. But since you are receiving IVIG at home, you can receive rituximab one day and IVIG on another day of the same week without an issue. Speak with your physician to make sure there are no other reasons this could not be the case based on your specific medical history.

“Is anyone tracking CLL and other cancer patients’ reactions and results from COVID-19 vaccines?” —Michael M.

Dr. Lamanna: Many of the CLL physicians are monitoring reactions, responses, COVID infections in CLL patients, etc. It will take some time to have data in this area. Some of us previously reported the outcome of CLL patients who developed COVID last spring.

“Is there any information regarding med allergies (sulfa, amoxicillin, levoflox) reactions to the COVID vaccine? Thank you.” —Loretta P.

Dr. Lamanna: Allergies to antibiotics does not mean that one will have a reaction to the COVID vaccine. If one has had a reaction to a prior vaccine, this needs to be discussed with your physician prior to receiving the COVID vaccine.

“I am a Naprapath and I now have had two Pfizer [COVID-19] shots. I know that I have to wait two weeks. My question is do I need to wait until my patients have had their two [COVID-19] shots, or am I safe to work on them now?” —Anna F.

Dr. Lamanna: This is a difficult question. Having received the vaccine means that hopefully if one were to be exposed, they won’t become seriously ill. We have no data regarding the COVID vaccine in CLL patients yet so we do not know how fully protective the vaccine will be in our patient population. It certainly would be more reassuring if your patients have had their vaccine, and hopefully, over time we will have some form of herd immunity. However, this is a difficult time and there are also COVID variants. It’s unclear if vaccines will cover all of the variants as of yet. But understandably people need to work as well — if you have been vaccinated and continue to wear appropriate PPE then likely this will reduce your risk greatly. This is a very personal decision, and one needs to weigh the pros and cons without much data.

“Wouldn’t it be helpful to know your level of spike antibodies in order to know what level of [COVID-19] precautions to take?” —John G.

Dr. Lamanna: Data regarding CLL and COVID vaccines is lacking at this time. Since we really do not know yet what the level of spike antibodies in a CLL patient may mean (i.e., how much protection in an individual CLL patient), this is not yet advocated. Stay tuned…

“Can you take the vaccine while you receive an antibody?” —Barb L.

Dr. Lamanna: The data is lacking but the concern about vaccine and monoclonal antibody therapy is that monoclonal antibody therapy may dampen one’s response to a vaccine. We do not know to what degree or variability as we do not have data. Thus, depending upon where someone is in their therapy course, this should be discussed with their individual physician.

Thank you to Dr. Lamanna and all of the experts who share their time and knowledge with the Patient Power community. We’ll continue to bring you the latest COVID-19 news as it happens. To learn more about CLL, watch programs featuring Dr. Nicole Lamanna.

~Suzanne Mooney

The Current CLL Treatment Landscape & Advocating for Your Care

Join Patient Power for a virtual town hall meeting for chronic lymphocytic leukemia (CLL) patients and family members on Saturday, March 20, 2021 starting at 10 am CT/11 am ET. The 3-hour program, produced in partnership with the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, will take patients through the current treatment landscape of CLL, including the latest news in research, state-of-the-art testing and personalized care. Send us your questions in advance to

Register Today!

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