Association of Convalescent Plasma Therapy with Survival in Patients with Hematologic Cancers and COVID-19

Michael A. Thompson, Jeffrey P. Henderson, Pankil K. Shah, Samuel M. Rubinstein, Michael J. Joyner, Toni K. Choueiri, Daniel B. Flora, Elizabeth A. Griffiths, Anthony P. Gulati, Clara Hwang, Vadim S. Koshkin, Esperanza B. Papadopoulos, Elizabeth V. Robilotti, Christopher T. Su, Elizabeth M. Wulff-Burchfield, Zhuoer Xie, Peter Paul Yu, Sanjay Mishra, Jonathon W. Senefeld, Dimpy P. ShahJeremy L. Warner

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Importance: COVID-19 is a life-threatening illness for many patients. Prior studies have established hematologic cancers as a risk factor associated with particularly poor outcomes from COVID-19. To our knowledge, no studies have established a beneficial role for anti-COVID-19 interventions in this at-risk population. Convalescent plasma therapy may benefit immunocompromised individuals with COVID-19, including those with hematologic cancers. Objective: To evaluate the association of convalescent plasma treatment with 30-day mortality in hospitalized adults with hematologic cancers and COVID-19 from a multi-institutional cohort. Design, Setting, and Participants: This retrospective cohort study using data from the COVID-19 and Cancer Consortium registry with propensity score matching evaluated patients with hematologic cancers who were hospitalized for COVID-19. Data were collected between March 17, 2020, and January 21, 2021. Exposures: Convalescent plasma treatment at any time during hospitalization. Main Outcomes and Measures: The main outcome was 30-day all-cause mortality. Cox proportional hazards regression analysis with adjustment for potential confounders was performed. Hazard ratios (HRs) are reported with 95% CIs. Secondary subgroup analyses were conducted on patients with severe COVID-19 who required mechanical ventilatory support and/or intensive care unit admission. Results: A total of 966 individuals (mean [SD] age, 65 [15] years; 539 [55.8%] male) were evaluated in this study; 143 convalescent plasma recipients were compared with 823 untreated control patients. After adjustment for potential confounding factors, convalescent plasma treatment was associated with improved 30-day mortality (HR, 0.60; 95% CI, 0.37-0.97). This association remained significant after propensity score matching (HR, 0.52; 95% CI, 0.29-0.92). Among the 338 patients admitted to the intensive care unit, mortality was significantly lower in convalescent plasma recipients compared with nonrecipients (HR for propensity score-matched comparison, 0.40; 95% CI, 0.20-0.80). Among the 227 patients who required mechanical ventilatory support, mortality was significantly lower in convalescent plasma recipients compared with nonrecipients (HR for propensity score-matched comparison, 0.32; 95% CI, 0.14-0.72). Conclusions and Relevance: The findings of this cohort study suggest a potential survival benefit in the administration of convalescent plasma to patients with hematologic cancers and COVID-19.

Original languageEnglish
Pages (from-to)1167-1175
Number of pages9
JournalJAMA oncology
Volume7
Issue number8
DOIs
StatePublished - Aug 2021

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