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Patients with cancer are at risk for immune dysregulation related to underlying malignant disease as well as receipt of immunomodulatory cancer therapy. A notable concern is that patients with cancer may not mount a robust protective immune response to SARS-CoV-2 infection or vaccination.1 This risk seems most pronounced in patients with hematologic cancers: in a study of 167 patients with chronic lymphocytic leukemia in Israel who had received both doses of the BNT162b2 messenger RNA (mRNA) vaccine (Pfizer-BioNTech) for COVID-19, only 39.5% had a positive antibody response, and this proportion was even lower (16%) among patients on active treatment.2 Patients with solid malignant neoplasms may have a more preserved immune response—of 261 patients with cancer in New York City who had tested positive for SARS-CoV-2, the rate of seroconversion was 94.5% for those with solid tumors compared with 81.7% with hematologic cancers.3
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Sun L, Warner JL, Parikh RB. Immune Responses to SARS-CoV-2 Among Patients With Cancer: What Can Seropositivity Tell Us? JAMA Oncol. Published online May 28, 2021. doi:10.1001/jamaoncol.2021.2096
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