The Moderna COVID-19 vaccine may be more effective than the Pfizer-BioNTech vaccine for patients with chronic lymphocytic leukemia (CLL), according to a study presented at the NCCN 2022 Annual Conference. 

Researchers found that patients with CLL were significantly more likely to have an antibody response to the Moderna vaccine, and there was a trend toward significance for patients with Waldenstrom’s macroglobulinemia (WM) as well.

The researchers conducted a single-center study of 240 patients with lymphoid malignancies — 181 with CLL, 21 with WM, and 38 with other non-Hodgkin lymphomas (NHLs). The patients’ mean age was 61 years, 64% were men, and 84% were Caucasian. 

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In the entire cohort, 42% of patients had not received any anticancer therapy, 21% were under surveillance after completing treatment, and 37% were on active therapy. In the CLL subgroup, 56% of patients were actively undergoing treatment for CLL or had received a prior therapy, and 44% had not received any treatment.

The researchers obtained antibody titers at 0 to 6 months after patients completed a vaccination series with the Pfizer-BioNTech vaccine, Moderna vaccine, Johnson & Johnson’s Janssen vaccine, or multiple brands.

The researchers used the Access SARS-COV-2 assay, and a response was defined as a positive total antibody or spike protein antibody result.


The proportion of patients with an antibody response to the initial vaccination series (without a booster dose) was 50% in the CLL group, 67% in the WM group, and 71% in the patients with other NHLs.

In the CLL group, the rate of antibody response was significantly higher with the Moderna vaccine than with the Pfizer-BioNTech vaccine — 61% and 44%, respectively (P =.028).

In the WM group, the antibody response rate was 88% with the Moderna vaccine and 54% with the Pfizer-BioNTech vaccine (P =.11). Among the patients with other NHLs, the antibody response rate was 80% and 70%, respectively (P =.56).

In the CLL group, patients who were receiving or had received CLL therapy had a lower rate of antibody response to any vaccine, when compared with treatment-naïve patients — 36% and 68%, respectively (P =.000019).

Among the treated CLL patients, the antibody response rate was 51% with the Moderna vaccine and 29% with the Pfizer-BioNTech vaccine (P =.026). Among CLL patients treated with a BTK inhibitor, the antibody response rate was 54% and 23%, respectively (P =.0072).

Regardless of the vaccine received, there was a significantly lower antibody response rate in CLL patients who received anti-CD20 agents within 1 year prior to receiving their first vaccine dose, compared with patients who had been treated more than 1 year prior — 13% and 40%, respectively (P =.022). This difference was observed after a booster dose as well — 10% and 64%, respectively (P =.0039).

There were 87 patients who had antibody test results available after the primary series and a booster dose. In this group, there was no significant difference in antibody response after the booster dose according to vaccine type in any malignancy.

However, this analysis was limited due to the small sample size, according to study author Peter Doukas, MD, of Northwestern Feinberg School of Medicine in Chicago.

He added that more research is needed to determine whether the difference in antibody response between the Moderna and Pfizer-BioNTech vaccines observed in CLL patients “persists after the booster vaccine and whether this yields any difference in mortality.”


Doukas PG, St. Pierre F, Boyer J, Nieves M, Ma S. Humoral immune response following COVID-19 vaccination in patients with chronic lymphocytic leukemia and other indolent lymphomas: A large, single-center observational study. Presented at NCCN 2022 Annual Conference; March 31 – April 2, 2022. Abstract CLO22-043.

This article originally appeared on Cancer Therapy Advisor