High COVID-19 Risk for Hematologic Malignancy Patients: Understanding Vulnerabilities and Protective Measures

September 10, 2025

COVID-19 Remains a Serious Threat to Patients with Blood Cancers

Despite the widespread availability of vaccines and a shift towards an endemic phase, peopel living with hematologic malignancies – blood cancers – continue to experience a significantly elevated risk of severe illness and death from COVID-19. A recent study underscores the ongoing vulnerability of this population, even among those who are fully vaccinated.

Elevated Risk Confirmed in Recent Study

Researchers at the University Hospital Renato dulbecco in Catanzaro conducted an observational study analyzing 85 adult patients with active hematologic malignancies diagnosed with COVID-19 between January 1, 2022, and December 31, 2023.The findings revealed that nearly 24% of patients experienced severe or critical illness, and the overall mortality rate associated with the virus reached 22.4%.

Multiple myeloma and non-Hodgkin lymphoma were the most prevalent types of cancer among the study participants, accounting for 33 and 30 cases, respectively. The median age of the patients was 69, and a majority were male. While most had received the COVID-19 vaccine, it did not fully protect against severe outcomes.

Factors Contributing to Increased Mortality

The study pinpointed several factors that increased the risk of mortality, including advanced age, active disease progression at the time of infection, and the need for intensive care unit (ICU) admission. Notably,the researchers observed a decline in the overall mortality rate over the study period,from 27.7% to 16.7%. However, the mortality rate remained alarmingly high – between 75% and 100% – for patients who developed critical illness.

A important finding highlighted the impact of progressing malignancy on COVID-19 mortality, with nearly 47.4% of deaths linked to cancer progression. This suggests that delays in cancer treatment due to COVID-19 infections can have devastating consequences.

hematologic Malignancies and COVID-19 Vulnerability: A Comparison

Condition	Case Fatality Rate (2021)
Hematologic Malignancies	14.9%
Solid Tumors	4.8%

Source: Başcı S, et al. Intern Emerg Med.2022; 17 (1): 135-139.

Did You Know? Individuals with compromised immune systems, like those undergoing cancer treatment, may not mount as strong an immune response to vaccines, making them more susceptible to severe infections.

Ongoing Research and Future Directions

Experts emphasize the need for continued research to understand the evolving impact of COVID-19 variants on patients with hematologic malignancies. proactive clinical adaptation and robust patient advocacy are crucial to improving outcomes for this high-risk population.

Pro Tip: Maintaining up-to-date vaccinations, practicing preventative measures like masking, and promptly seeking medical attention upon contracting COVID-19 are crucial steps for individuals with hematologic malignancies.

the findings have implications for healthcare providers, who should prioritize vigilance and preventative strategies for thes vulnerable patients as the virus continues to circulate.

Understanding Hematologic Malignancies

Hematologic malignancies, encompassing leukemias, lymphomas, and myelomas, disrupt the normal production of blood cells. These cancers often compromise the immune system, making individuals more susceptible to infections. Current treatment regimes,while effective,frequently involve immunosuppression,further increasing vulnerability.

The COVID-19 pandemic highlighted the critical need for tailored strategies to protect this patient population.Research continues to refine vaccination protocols and explore novel therapeutic interventions to mitigate the risks associated with COVID-19 infection.

Frequently Asked Questions about COVID-19 and Blood Cancers

• what is a hematologic malignancy? Hematologic malignancies are cancers that affect the blood, bone marrow, and lymphatic system.
• Are vaccinated cancer patients still at risk from COVID-19? Yes, while vaccination reduces risk, patients with hematologic malignancies remain vulnerable to severe illness.
• What factors increase the risk of death from COVID-19 in cancer patients? Advanced age, active disease, and requiring ICU care are significant risk factors.
• Can COVID-19 treatment be delayed in cancer patients? Yes, and delays in cancer treatment can negatively impact survival rates.
• What can cancer patients do to protect themselves from COVID-19? Staying up-to-date on vaccinations,practicing good hygiene,and seeking early medical attention are crucial.

What are your thoughts on the ongoing challenges faced by immunocompromised individuals during the pandemic? Share your comments below!

What specific immune cell deficiencies are most strongly correlated with increased severity of COVID-19 in patients with hematologic malignancies?

Why Hematologic Malignancies Increase COVID-19 Susceptibility

Patients battling hematologic malignancies – cancers of the blood,bone marrow,and lymphatic system – face a significantly elevated risk from COVID-19. This isn’t simply due to a compromised immune system, though that’s a major factor. Several interconnected elements contribute to this heightened vulnerability.understanding these is crucial for proactive protection.

Immunosuppression: Chemotherapy, radiation therapy, stem cell transplantation, and the malignancies themselves all suppress the immune system.this diminished capacity to fight off infections,including SARS-CoV-2 (the virus causing COVID-19),is paramount.

Neutropenia: Many hematologic cancers and their treatments cause neutropenia – a low count of neutrophils, a type of white blood cell vital for fighting bacterial and viral infections. Neutropenic patients are exceptionally susceptible to severe COVID-19 outcomes.

Lymphopenia: A reduction in lymphocytes (another type of white blood cell) is common in these patients, further weakening the immune response. COVID-19 directly attacks lymphocytes, exacerbating this issue.

Underlying Conditions: Many patients with hematologic malignancies have pre-existing conditions,such as heart disease or lung disease,which independently increase COVID-19 risk.

Treatment Delays: Fear of COVID-19 exposure can lead to delays in essential cancer treatment,potentially worsening the prognosis for both conditions.

Specific Hematologic Malignancies & COVID-19 Risk

The level of risk varies depending on the specific type of hematologic malignancy and the patient’s treatment status.

Acute Leukemia (AML, ALL): Patients undergoing induction chemotherapy are at the highest risk due to profound immunosuppression and prolonged neutropenia.

Lymphoma (Hodgkin & Non-Hodgkin): Risk depends on the stage, subtype, and treatment regimen. Patients receiving intensive chemotherapy or undergoing stem cell transplant are especially vulnerable.

Multiple Myeloma: While often less aggressive than acute leukemias, multiple myeloma patients treated with proteasome inhibitors or undergoing autologous stem cell transplant are at increased risk.

Myelodysplastic Syndromes (MDS): Patients with MDS often have underlying cytopenias (low blood cell counts) and may require immunosuppressive therapy, increasing their susceptibility.

Chronic Lymphocytic Leukemia (CLL): CLL patients, especially those with advanced disease or undergoing chemoimmunotherapy, are at higher risk of severe COVID-19.

COVID-19 Vaccination in Hematologic Malignancy Patients

Vaccination remains the most effective strategy for protecting against severe COVID-19, even in immunocompromised individuals. However,the immune response to COVID-19 vaccines may be reduced in patients with hematologic malignancies.

Vaccine Types: mRNA vaccines (Pfizer-BioNTech, Moderna) are generally preferred, though availability may vary.

Booster Doses: The CDC and WHO recommend that immunocompromised individuals receive an additional dose of the COVID-19 vaccine. Staying up-to-date with boosters is critical. As of September 2025, updated vaccines targeting current variants are available and highly recommended.

Antibody Testing: While antibody testing after vaccination can provide some information, it doesn’t reliably predict protection.Focus on vaccination and boosters rather than relying solely on antibody levels.

Family & Close Contact Vaccination: Encourage all household members and close contacts to be fully vaccinated and boosted to create a “cocoon” of protection around the patient.

Proactive Protective Measures: Beyond Vaccination

Vaccination is a cornerstone, but a multi-layered approach is essential.

1. Masking: consistent mask use (N95 or KN95 masks are preferred) in public indoor settings, especially during periods of high community transmission.
2. Social Distancing: Maintaining physical distance from others whenever possible.
3. Hand Hygiene: Frequent handwashing with soap and water or using alcohol-based hand sanitizer.
4. Avoidance of Crowds: Limiting exposure to large gatherings and crowded spaces.
5. Ventilation: Improving indoor ventilation by opening windows or using air purifiers with HEPA filters.
6. Monoclonal Antibody Therapy & Antiviral Medications: early treatment with monoclonal antibodies (if available and appropriate) or antiviral medications like Paxlovid can significantly reduce the risk of hospitalization and death. Prompt medical attention is crucial.
7. Regular Monitoring: Close monitoring for COVID-19 symptoms and prompt testing if symptoms develop.
8. Telehealth Appointments: Utilize telehealth appointments whenever possible to minimize exposure.

Real-World Example: Managing COVID-19 in a Stem cell Transplant Recipient

In early 2025, a 48-year-old male undergoing allogeneic stem cell transplant for