Physician-scientist and lymphoma expert Santosha Vardhana has been on the frontlines of treating cancer patients infected with COVID-19.
Doctors and scientists at Memorial Sloan Kettering Cancer Center have played a leading role in understanding how COVID-19 affects people with cancer. MSK investigators have published a number of pioneering studies on the topic, which have contributed to the care of patients all over the world.
When the pandemic struck in the spring of 2020, New York City was the epicenter of the first wave of infections in the United States. That unfortunate geography for MSK, combined with its focus on treating cancer, quickly resulted in a medical team with unmatched expertise in treating COVID-19 infections in this potentially vulnerable population.
MSK experts recognized early on that people with blood cancers were among the most affected by COVID-19. Some blood cancers directly affect patients’ immune systems, making it harder for their bodies to stave off any infection. For other types of blood cancer, the treatments greatly diminish the body’s ability to fight an infection once it’s in the body.
Clinical Observations Drive New Research
Specialists in many disciplines across MSK — including leukemia, lymphoma, multiple myeloma, and blood and marrow stem cell transplantation, as well as laboratory medicine, infectious diseases, and computational biology — banded together to take care of sick patients and to conduct research with the hope of benefiting patients everywhere.
“COVID-19 research is a story of translational investigations that came out of clinical and bedside observations,” says MSK physician-scientist Santosha Vardhana, a member of the Lymphoma Service, who spent several weeks caring for patients who had been admitted to MSK with severe COVID-19. “We observed that in patients with blood cancers, the disease was not behaving the way it did in others.”
A Focus on Better Treatments
Dr. Vardhana and his collaborators, many of whom are members of MSK’s Center for Hematologic Malignancies, took patient samples into the lab to learn what was happening. They expected that patients with low numbers of B cells would do poorly, because B cells are responsible for making antibodies (infection-fighting molecules). But the patient samples revealed something different.
“We actually found that patients without B cell function did OK,” Dr. Vardhana says. “It was patients whose T cells were not working properly who had very poor outcomes.”
T cells are the immune system’s primary cellular defense against viral invaders. When patients lacked T cells, they were unlikely to clear the virus that causes COVID-19. Some remained infected for months, getting progressively sicker.
“It was a real struggle for these patients, and some of them ultimately died from COVID-19,” Dr. Vardhana adds. “The really important thing for us is to understand what happened so that we can continue to develop better ways to treat infection in these at-risk patients.” In the future, Dr. Vardhana and his colleagues plan to test new treatments for patients who are unable to mount an immune response due to their cancer or its treatment.
Looking at Vaccine Response
A more recent emphasis for researchers at MSK is studying how people in active treatment for blood cancers respond to vaccines. It’s well known that these cancer treatments can greatly diminish the body’s ability to create and deploy antibodies after vaccination. A tragic example is former Secretary of State Colin Powell, who was in treatment for multiple myeloma and died from COVID-19 in October 2021, despite being vaccinated.
“There are many different kinds of drugs used to treat blood cancer, and we have learned that there clearly are major differences in the immune system’s response to the vaccine, depending on which drugs you’re getting,” Dr. Vardhana says. This is something he and his colleagues will continue to study.
“Widespread community vaccination is so important,” he emphasizes. “There are some people who cannot be completely protected, even with all of our best available tools.”
Especially with the growing concerns about the Omicron variant, Dr. Vardhana says, it’s critical that everyone not only be vaccinated but also get a booster shot.
- When the COVID-19 pandemic first struck in 2020, MSK’s doctors and researchers quickly became experts in treating infections in people with cancer.
- MSK investigators have led many studies looking at how people with blood cancers responded to infection.
- Researchers use patient samples to learn more about how infections behave in this vulnerable population.
- Members of MSK’s Center for Hematologic Malignancies are now studying how people with blood cancers respond to COVID-19 vaccines.
