NCT05170399

Brief Summary

Background: People with B cell malignancies (blood cancers) often cannot mount a full immune response to infections or certain vaccines. Bruton tyrosine kinase inhibitors (BTKis), which are used to treat blood cancers, may also negatively affect a person s response to certain vaccines. Researchers want to learn more about vaccine responses in people with certain types of blood cancers. The findings may help develop better vaccine strategies for people with these cancers. Objective: To learn how well vaccines work in people who have certain types of blood cancers. Eligibility: Adults aged 18 years or older who have chronic lymphocytic leukemia (CLL), Waldenstrom macroglobulinemia, or certain non-Hodgkin lymphomas. Design: Participants will get one or more vaccines for illnesses such as COVID-19, hepatitis B, and shingles. They can choose which vaccines they receive. They will give a blood sample before they get each vaccine. Some vaccines require a second dose 3-6 weeks later. Participants may give an optional blood sample with the second vaccine dose. About 4 weeks after they finish each vaccine series, they will give another blood sample. They will have 2-3 study visits per vaccine. Participants may receive a booster dose for some vaccines. The booster dose is optional. They will give another blood sample with the booster dose. Participants will have pregnancy tests, if needed. Participants with CLL who receive BTKis may be asked to pause treatment for up to 7 weeks. Participants may give follow-up blood samples up to 2 times a year for 5 years. These blood samples are optional. Participation will last for up to 5 years after each vaccine series is received.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
500

participants targeted

Target at P75+ for phase_4 lymphoma

Timeline
4mo left

Started Sep 2022

Typical duration for phase_4 lymphoma

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress93%
Sep 2022Aug 2026

First Submitted

Initial submission to the registry

December 24, 2021

Completed
4 days until next milestone

First Posted

Study publicly available on registry

December 28, 2021

Completed
9 months until next milestone

Study Start

First participant enrolled

September 14, 2022

Completed
3.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 16, 2026

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

August 16, 2026

Last Updated

February 5, 2026

Status Verified

February 2, 2026

Enrollment Period

3.9 years

First QC Date

December 24, 2021

Last Update Submit

February 4, 2026

Conditions

Keywords

CLLSLLBoosterLymphomaVaccines

Outcome Measures

Primary Outcomes (1)

  • Serologic response against each administered vaccine following completion of the vaccine series in each study arm

    vaccine titer

    4 weeks after completing vaccine series

Study Arms (9)

Chronic Lymphocytic Leukemia Not Receiving Active Treatment

EXPERIMENTAL

Participants may receive one or more of the following vaccine types: Shingrix, Heplisav -B, Fluzone, Afluria, Fluarix, Flucelvax, FluLaval, PREVNAR 13, PNEUMOVAX 23, Pfizer-COVID-19, Moderna-COVID-19 and receive assessment of serologic and cellular response following completion of each vaccine series.

Biological: FluzoneBiological: ShingrixBiological: FlucelvaxBiological: AfluriaBiological: PREVNAR 13Biological: Heplisav -BBiological: Pfizer-COVID-19 VaccineBiological: FluLavalBiological: FluarixBiological: PNEUMOVAX 23Drug: PREVNAR 20Drug: AREXVY, ABRYSVO

Chronic Lymphocytic Leukemia Treatment Break for BTKi

EXPERIMENTAL

Participants may receive one or more of the following vaccine types: Shingrix, Heplisav -B, Fluzone, Afluria, Fluarix, Flucelvax, FluLaval, PREVNAR 13, PNEUMOVAX 23, Pfizer-COVID-19, Moderna-COVID-19 and receive assessment of serologic and cellular response following completion of each vaccine series.

Biological: FluzoneBiological: ShingrixBiological: FlucelvaxBiological: AfluriaBiological: PREVNAR 13Biological: Heplisav -BBiological: Pfizer-COVID-19 VaccineBiological: FluLavalBiological: FluarixBiological: PNEUMOVAX 23Drug: PREVNAR 20Drug: AREXVY, ABRYSVO

Chronic Lymphocytic Leukemia Treatment Naive

EXPERIMENTAL

Participants may receive one or more of the following vaccine types: Shingrix, Heplisav -B, Fluzone, Afluria, Fluarix, Flucelvax, FluLaval, PREVNAR 13, PNEUMOVAX 23, Pfizer-COVID-19, Moderna-COVID-19 and receive assessment of serologic and cellular response following completion of each vaccine series.

Biological: FluzoneBiological: ShingrixBiological: FlucelvaxBiological: AfluriaBiological: PREVNAR 13Biological: Heplisav -BBiological: Pfizer-COVID-19 VaccineBiological: FluLavalBiological: FluarixBiological: PNEUMOVAX 23Drug: PREVNAR 20Drug: AREXVY, ABRYSVO

Chronic Lymphocytic Leukemia Treatment with BTKi

EXPERIMENTAL

Participants may receive one or more of the following vaccine types: Shingrix, Heplisav -B, Fluzone, Afluria, Fluarix, Flucelvax, FluLaval, PREVNAR 13, PNEUMOVAX 23, Pfizer-COVID-19, Moderna-COVID-19 and receive assessment of serologic and cellular response following completion of each vaccine series.

Biological: FluzoneBiological: ShingrixBiological: FlucelvaxBiological: AfluriaBiological: PREVNAR 13Biological: Heplisav -BBiological: Pfizer-COVID-19 VaccineBiological: FluLavalBiological: FluarixBiological: PNEUMOVAX 23Drug: PREVNAR 20Drug: AREXVY, ABRYSVO

Follicular Lymphoma

EXPERIMENTAL

Participants may receive one or more of the following vaccine types: Shingrix, Heplisav -B, Fluzone, Afluria, Fluarix, Flucelvax, FluLaval, PREVNAR 13, PNEUMOVAX 23, Pfizer-COVID-19, Moderna-COVID-19 and receive assessment of serologic and cellular response following completion of each vaccine series.

Biological: FluzoneBiological: ShingrixBiological: FlucelvaxBiological: AfluriaBiological: PREVNAR 13Biological: Heplisav -BBiological: Pfizer-COVID-19 VaccineBiological: FluLavalBiological: FluarixBiological: PNEUMOVAX 23Drug: PREVNAR 20Drug: AREXVY, ABRYSVO

Follicular Lymphoma Treatment Naive

EXPERIMENTAL

Participants may receive one or more of the following vaccine types: Shingrix, Heplisav -B, Fluzone, Afluria, Fluarix, Flucelvax, FluLaval, PREVNAR 13, PNEUMOVAX 23, Pfizer-COVID-19, Moderna-COVID-19 and receive assessment of serologic and cellular response following completion of each vaccine series.

Biological: FluzoneBiological: ShingrixBiological: FlucelvaxBiological: AfluriaBiological: PREVNAR 13Biological: Heplisav -BBiological: Pfizer-COVID-19 VaccineBiological: FluLavalBiological: FluarixBiological: PNEUMOVAX 23Drug: PREVNAR 20Drug: AREXVY, ABRYSVO

Other Non-Hodgkin Lymphoma and Waldenstrom Macroglobulinemia

EXPERIMENTAL

Participants may receive one or more of the following vaccine types: Shingrix, Heplisav -B, Fluzone, Afluria, Fluarix, Flucelvax, FluLaval, PREVNAR 13, PNEUMOVAX 23, Pfizer-COVID-19, Moderna-COVID-19 and receive assessment of serologic and cellular response following completion of each vaccine series.

Biological: FluzoneBiological: ShingrixBiological: FlucelvaxBiological: AfluriaBiological: PREVNAR 13Biological: Heplisav -BBiological: Pfizer-COVID-19 VaccineBiological: FluLavalBiological: FluarixBiological: PNEUMOVAX 23Drug: PREVNAR 20Drug: AREXVY, ABRYSVO

Other Non-Hodgkin Lymphoma and Waldenstrom Macroglobulinemia - Treatment with Targeted Therapies

EXPERIMENTAL

Participants may receive one or more of the following vaccine types: Shingrix, Heplisav -B, Fluzone, Afluria, Fluarix, Flucelvax, FluLaval, PREVNAR 13, PNEUMOVAX 23, Pfizer-COVID-19, and receive assessment of serologic and cellular response following completion of each vaccine series.

Biological: FluzoneBiological: ShingrixBiological: FlucelvaxBiological: AfluriaBiological: PREVNAR 13Biological: Heplisav -BBiological: Pfizer-COVID-19 VaccineBiological: FluLavalBiological: FluarixBiological: PNEUMOVAX 23Drug: PREVNAR 20Drug: AREXVY, ABRYSVO

Participants diagnosed with Chronic Lymphocytic Leukemia (CLL)

EXPERIMENTAL

Participants may receive one or more of the following vaccine types: Shingrix, Heplisav -B, Fluzone, Afluria, Fluarix, Flucelvax, FluLaval, PREVNAR 13, PNEUMOVAX 23, Pfizer-COVID-19, Moderna-COVID-19 and receive assessment of serologic and cellular response following completion of each vaccine series.

Biological: FluzoneBiological: ShingrixBiological: FlucelvaxBiological: AfluriaBiological: PREVNAR 13Biological: Heplisav -BBiological: Pfizer-COVID-19 VaccineBiological: FluLavalBiological: FluarixBiological: PNEUMOVAX 23Drug: PREVNAR 20Drug: AREXVY, ABRYSVO

Interventions

PNEUMOVAX 23BIOLOGICAL

Pneumococcal Polysaccharide Vaccine (PPSV23)

Chronic Lymphocytic Leukemia Not Receiving Active TreatmentChronic Lymphocytic Leukemia Treatment Break for BTKiChronic Lymphocytic Leukemia Treatment NaiveChronic Lymphocytic Leukemia Treatment with BTKiFollicular LymphomaFollicular Lymphoma Treatment NaiveOther Non-Hodgkin Lymphoma and Waldenstrom MacroglobulinemiaOther Non-Hodgkin Lymphoma and Waldenstrom Macroglobulinemia - Treatment with Targeted TherapiesParticipants diagnosed with Chronic Lymphocytic Leukemia (CLL)

Pneumococcal 20-Valent Conjugate Vaccine (PCV20)

Chronic Lymphocytic Leukemia Not Receiving Active TreatmentChronic Lymphocytic Leukemia Treatment Break for BTKiChronic Lymphocytic Leukemia Treatment NaiveChronic Lymphocytic Leukemia Treatment with BTKiFollicular LymphomaFollicular Lymphoma Treatment NaiveOther Non-Hodgkin Lymphoma and Waldenstrom MacroglobulinemiaOther Non-Hodgkin Lymphoma and Waldenstrom Macroglobulinemia - Treatment with Targeted TherapiesParticipants diagnosed with Chronic Lymphocytic Leukemia (CLL)

Respiratory Syncytial Virus Vaccine

Chronic Lymphocytic Leukemia Not Receiving Active TreatmentChronic Lymphocytic Leukemia Treatment Break for BTKiChronic Lymphocytic Leukemia Treatment NaiveChronic Lymphocytic Leukemia Treatment with BTKiFollicular LymphomaFollicular Lymphoma Treatment NaiveOther Non-Hodgkin Lymphoma and Waldenstrom MacroglobulinemiaOther Non-Hodgkin Lymphoma and Waldenstrom Macroglobulinemia - Treatment with Targeted TherapiesParticipants diagnosed with Chronic Lymphocytic Leukemia (CLL)
FluzoneBIOLOGICAL

Annual Influenza Vaccine

Chronic Lymphocytic Leukemia Not Receiving Active TreatmentChronic Lymphocytic Leukemia Treatment Break for BTKiChronic Lymphocytic Leukemia Treatment NaiveChronic Lymphocytic Leukemia Treatment with BTKiFollicular LymphomaFollicular Lymphoma Treatment NaiveOther Non-Hodgkin Lymphoma and Waldenstrom MacroglobulinemiaOther Non-Hodgkin Lymphoma and Waldenstrom Macroglobulinemia - Treatment with Targeted TherapiesParticipants diagnosed with Chronic Lymphocytic Leukemia (CLL)
ShingrixBIOLOGICAL

Recombinant, adjuvanted Zoster Vaccine (RZV)

Chronic Lymphocytic Leukemia Not Receiving Active TreatmentChronic Lymphocytic Leukemia Treatment Break for BTKiChronic Lymphocytic Leukemia Treatment NaiveChronic Lymphocytic Leukemia Treatment with BTKiFollicular LymphomaFollicular Lymphoma Treatment NaiveOther Non-Hodgkin Lymphoma and Waldenstrom MacroglobulinemiaOther Non-Hodgkin Lymphoma and Waldenstrom Macroglobulinemia - Treatment with Targeted TherapiesParticipants diagnosed with Chronic Lymphocytic Leukemia (CLL)
FlucelvaxBIOLOGICAL

Annual Influenza Vaccine

Chronic Lymphocytic Leukemia Not Receiving Active TreatmentChronic Lymphocytic Leukemia Treatment Break for BTKiChronic Lymphocytic Leukemia Treatment NaiveChronic Lymphocytic Leukemia Treatment with BTKiFollicular LymphomaFollicular Lymphoma Treatment NaiveOther Non-Hodgkin Lymphoma and Waldenstrom MacroglobulinemiaOther Non-Hodgkin Lymphoma and Waldenstrom Macroglobulinemia - Treatment with Targeted TherapiesParticipants diagnosed with Chronic Lymphocytic Leukemia (CLL)
AfluriaBIOLOGICAL

Annual Influenza Vaccine

Chronic Lymphocytic Leukemia Not Receiving Active TreatmentChronic Lymphocytic Leukemia Treatment Break for BTKiChronic Lymphocytic Leukemia Treatment NaiveChronic Lymphocytic Leukemia Treatment with BTKiFollicular LymphomaFollicular Lymphoma Treatment NaiveOther Non-Hodgkin Lymphoma and Waldenstrom MacroglobulinemiaOther Non-Hodgkin Lymphoma and Waldenstrom Macroglobulinemia - Treatment with Targeted TherapiesParticipants diagnosed with Chronic Lymphocytic Leukemia (CLL)
PREVNAR 13BIOLOGICAL

Pneumococcal Conjugate Vaccine (PCV13)

Chronic Lymphocytic Leukemia Not Receiving Active TreatmentChronic Lymphocytic Leukemia Treatment Break for BTKiChronic Lymphocytic Leukemia Treatment NaiveChronic Lymphocytic Leukemia Treatment with BTKiFollicular LymphomaFollicular Lymphoma Treatment NaiveOther Non-Hodgkin Lymphoma and Waldenstrom MacroglobulinemiaOther Non-Hodgkin Lymphoma and Waldenstrom Macroglobulinemia - Treatment with Targeted TherapiesParticipants diagnosed with Chronic Lymphocytic Leukemia (CLL)
Heplisav -BBIOLOGICAL

Recombinant, adjuvanted Hepatitis (HepB-CpG)

Chronic Lymphocytic Leukemia Not Receiving Active TreatmentChronic Lymphocytic Leukemia Treatment Break for BTKiChronic Lymphocytic Leukemia Treatment NaiveChronic Lymphocytic Leukemia Treatment with BTKiFollicular LymphomaFollicular Lymphoma Treatment NaiveOther Non-Hodgkin Lymphoma and Waldenstrom MacroglobulinemiaOther Non-Hodgkin Lymphoma and Waldenstrom Macroglobulinemia - Treatment with Targeted TherapiesParticipants diagnosed with Chronic Lymphocytic Leukemia (CLL)

COVID-19 Vaccine

Chronic Lymphocytic Leukemia Not Receiving Active TreatmentChronic Lymphocytic Leukemia Treatment Break for BTKiChronic Lymphocytic Leukemia Treatment NaiveChronic Lymphocytic Leukemia Treatment with BTKiFollicular LymphomaFollicular Lymphoma Treatment NaiveOther Non-Hodgkin Lymphoma and Waldenstrom MacroglobulinemiaOther Non-Hodgkin Lymphoma and Waldenstrom Macroglobulinemia - Treatment with Targeted TherapiesParticipants diagnosed with Chronic Lymphocytic Leukemia (CLL)
FluLavalBIOLOGICAL

Annual Influenza Vaccine

Chronic Lymphocytic Leukemia Not Receiving Active TreatmentChronic Lymphocytic Leukemia Treatment Break for BTKiChronic Lymphocytic Leukemia Treatment NaiveChronic Lymphocytic Leukemia Treatment with BTKiFollicular LymphomaFollicular Lymphoma Treatment NaiveOther Non-Hodgkin Lymphoma and Waldenstrom MacroglobulinemiaOther Non-Hodgkin Lymphoma and Waldenstrom Macroglobulinemia - Treatment with Targeted TherapiesParticipants diagnosed with Chronic Lymphocytic Leukemia (CLL)
FluarixBIOLOGICAL

Annual Influenza Vaccine

Chronic Lymphocytic Leukemia Not Receiving Active TreatmentChronic Lymphocytic Leukemia Treatment Break for BTKiChronic Lymphocytic Leukemia Treatment NaiveChronic Lymphocytic Leukemia Treatment with BTKiFollicular LymphomaFollicular Lymphoma Treatment NaiveOther Non-Hodgkin Lymphoma and Waldenstrom MacroglobulinemiaOther Non-Hodgkin Lymphoma and Waldenstrom Macroglobulinemia - Treatment with Targeted TherapiesParticipants diagnosed with Chronic Lymphocytic Leukemia (CLL)

Eligibility Criteria

Age18 Years - 90 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Diagnosis of CLL, FL, MCL, MZL, NHL NOS or WM
  • Must fulfil one of the following criteria to be enrolled in one study arm per vaccine received:
  • Patients with CLL AND one of the following:
  • i. Arm 1: Must be treatment naive (no prior cancer directed therapy)
  • ii. Arm 2: Patients that have received prior cancer directed therapy and are currently not receiving active treatment
  • iii. Arm 3: Must be receiving treatment with a BTKi. This arm is not available to patients receiving the HEPLISAV-B vaccine
  • iv. Arm 4: Must be receiving treatment with a BTKi for \>= 6 months prior to vaccination and be willing to hold their treatment for up to 7 weeks around the time of each vaccination. This arm is not available to patients who have had a prior episode of disease flare during periods of drug hold, or for patients with CLL that is actively progressing.
  • v. Arm 5: Must be receiving treatment with a BCL-2 inhibitor
  • Patients with FL, MCL, MZL, NHL NOS or WM AND one of the following:
  • i. Arm 1: Must currently not be receiving active treatment (treatment na(SqrRoot) ve or previously treated)
  • ii. Arm 2: Must be receiving treatment with targeted therapies (e.g. BTKi, BCL-2 inhibitors, PI3K inhibitors, immunomodulatory agents, proteasome inhibitors)
  • If prior exposure to Hepatitis-B vaccination, must have documentation of negative serologic response
  • Age \>= 18 years
  • Able to comprehend the investigational nature of the protocol and provide informed consent

You may not qualify if:

  • Female patients who are currently pregnant
  • History of severe allergic reaction to vaccines
  • Concomitant inherited immunodeficiency
  • Any life-threatening illness, medical condition, or organ system dysfunction that, in the investigator s opinion, could compromise the subject s safety or put the study outcomes at undue risk.
  • Receive cytotoxic chemotherapy within 2 weeks prior to vaccination
  • Receive intravenous immunoglobulin (IVIG) within 2 months prior to vaccination
  • Receive anti-CD20 and/or anti-CD19 monoclonal antibody therapy within 6 months prior to vaccination
  • Receive cellular therapy (e.g. CAR-T cells) within 12 months prior to vaccination
  • History of allogeneic stem cell transplantation

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

National Institutes of Health Clinical Center

Bethesda, Maryland, 20892, United States

RECRUITING

Related Links

MeSH Terms

Conditions

Lymphoma

Interventions

Influenza VaccinesAfluria13-valent pneumococcal vaccineHeplisav-BBNT162 VaccineFluLavalfluarix23-valent pneumococcal capsular polysaccharide vaccinearexvyabrysvo

Condition Hierarchy (Ancestors)

Neoplasms by Histologic TypeNeoplasmsLymphoproliferative DisordersLymphatic DiseasesHemic and Lymphatic DiseasesImmunoproliferative DisordersImmune System Diseases

Intervention Hierarchy (Ancestors)

Viral VaccinesVaccinesBiological ProductsComplex MixturesmRNA VaccinesNucleic Acid-Based VaccinesVaccines, SyntheticRecombinant ProteinsProteinsAmino Acids, Peptides, and ProteinsCOVID-19 VaccinesAntigensBiological Factors

Study Officials

  • Adrian U Wiestner, M.D.

    National Heart, Lung, and Blood Institute (NHLBI)

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Adrian U Wiestner, M.D.

CONTACT

Study Design

Study Type
interventional
Phase
phase 4
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
BASIC SCIENCE
Intervention Model
PARALLEL
Sponsor Type
NIH
Responsible Party
SPONSOR

Study Record Dates

First Submitted

December 24, 2021

First Posted

December 28, 2021

Study Start

September 14, 2022

Primary Completion (Estimated)

August 16, 2026

Study Completion (Estimated)

August 16, 2026

Last Updated

February 5, 2026

Record last verified: 2026-02-02

Locations