Ask The Experts About Lymphoma

TraceyS

The Personalized Medicine Foundation and CancerConnect are pleased to provide patients and caregivers the opportunity to ask questions about lymphoma. We have put together a panel of leading cancer experts to answer questions and publish a forum for the exchange of information.

  • Michael L. Grossbard, MD Professor of Medicine, NYU Grossman School of Medicine Chief, Section of Hematology Perlmutter Cancer Center
  • C.H. Weaver M.D. Is the Executive Editor of CancerConnect who’s clinical research interests included stem cell transplantation in lymphoma and myeloma where he authored ~ 75 articles in major medical journals.

Please submit your questions you will be notified when the responses are posted.

Click here to submit your question.

Can breast silicone implants cause blood cancers like lymphoma or polycythemia vera?

A particular type of breast implants referred to as textured silicone implants have been associated with the development of a subtype of lymphoma in the breast known as anaplastic large cell lymphoma. This remains a rare entity with only 1000-2000 cases reported worldwide. The lymphoma can often be treated by removal of the implants which can lead to regression of the lymphoma. I am not aware of a relationship between silicone implants and polycythemia. Breast Implants and anaplastic large cell lymphoma.

Are you recommending the vaccine to your patients with lymphoma

Having cancer regardless of treatment status is a risk factor for worse outcome from infections including influenza and COVID-19. The short answer is yes once COVID-19 vaccines become more widely available. In terms of prioritization, and according to CDC guidelines, cancer patients will be part of the phase II wave of vaccination which will occur sometime in February. The vaccine is given in 2 doses at 21 days interval and we expect patients receiving the vaccine to be immune 2-3 weeks after their second dose of vaccine. Learn more about vaccination here.

Would there be any particular timing for a vaccination for a patient with marginal cell lymphoma, first Rituximab treatment March 2020, being followed by maintenance every 6 months (Ocotober 2020, May 2021 etc for 2 years) Pretty sure only mRNA is available.

We have no data on the optimal timing of COVID-19 vaccines for patients receiving Rituximab. The effects of Rituximab on B-cell numbers and the immune system last a long time and it is possible that the effectiveness of the vaccine may be lower in patients on Rituximab or other immunosuppressive agents, but it is still valuable to receive the vaccine. We and others are studying the question of the effectiveness of the COVID-19 vaccine in patients receiving therapy for lymphoma.

​I have a blood cancer and am taking hydroxyurea and have compromised immune system and take prolia for bones, is it ok to get covid vaccine. I am 83 yrs old in ok health.

The short answer is yes, the vaccines however were not evaluated in patients with blood disorders and compromised immune systems so we are not certain how effective they will be - the CDC is recommending cancer patients should get the vaccine. You should however discuss vaccination with the doctor managing your CMML. Here is a summary of what is known thus far about vaccination in patients with cancer.

I am concerned about the safety of the two RNA vaccines in general. Are they continued to be studied for safety even as people are getting them. Are there any studies on the safety and efficacy in lymphoma patients and these vaccines.

So far data shows excellent safety, most of vaccines adverse events occur on short term historically and there had been no concerns with the mRNA vaccines and enough follow up now in terms of safety, we don’t have data on efficacy among patients with MPN, there is zero harm as the vaccine does not contain any virus killed or attenuated.

What is your approach to timing of the Covid vaccination for patients with lymphoma who have not have had prior Covid 19, and are about to start chemotherapy?

If possible to delay, is it advised to delay starting chemo until 2 weeks after completing the Covid 19 vaccine series in order to max out the protective benefit from the vaccine. If starting Jakafi maybe delay starting Jakafi if possible by 2 weeks because it does affect T cell function.

My friend says that the Pfizer mRNA vaccine may cause covid19 illness in some people, is it true?

Absolutely not , there is no virus in the vaccine​.

Here is a summary of what is known thus far about vaccination in patients with cancer.

The Ask The Expert Series is made possible by support from The Personalized Medicine Foundation, Incyte Oncolgy, Abbvie, and CancerConnect. The "Ask The Expert" series is not medical advice nor is it a substitute for your doctor. It should serve as a guide to facilitate access to additional information and enhancement of a shared decision making process with your treating physician.
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