Vaccinations in patients with chronic lymphocytic leukemia

Semin Hematol. 2024 Jan 6:S0037-1963(24)00004-0. doi: 10.1053/j.seminhematol.2024.01.003. Online ahead of print.

Abstract

Chronic lymphocytic leukemia (CLL) is characterized by immune dysfunction resulting in heightened susceptibility to infections and elevated rates of morbidity and mortality. A key strategy to mitigate infection-related complications has been immunization against common pathogens. However, the immunocompromised status of CLL patients poses challenges in eliciting an adequate humoral and cellular immune response to vaccination. Most CLL-directed therapy disproportionately impairs humoral immunity. Vaccine responsiveness also depends on the phase and type of immune response triggered by immunization. In this review, we discuss the immune dysfunction, vaccine responsiveness, and considerations for optimizing vaccine response in patients with CLL.

Keywords: CLL; COVID-19; Chronic lymphocytic leukemia; Hepatitis B; Herpes zoster; Immune dysfunction; Influenza; Pneumococcal; TDaP; Vaccine.