Association of convalescent plasma therapy with survival in patients with hematologic cancers and COVID-19 Journal Article


Authors: Thompson, M. A.; Henderson, J. P.; Shah, P. K.; Rubinstein, S. M.; Joyner, M. J.; Choueiri, T. K.; Flora, D. B.; Griffiths, E. A.; Gulati, A. P.; Hwang, C.; Koshkin, V. S.; Papadopoulos, E. B.; Robilotti, E. V.; Su, C. T.; Wulff-Burchfield, E. M.; Xie, Z.; Yu, P. P.; Mishra, S.; Senefeld, J. W.; Shah, D. P.; Warner, J. L.
Article Title: Association of convalescent plasma therapy with survival in patients with hematologic cancers and COVID-19
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. © 2021 American Medical Association. All rights reserved.
Journal Title: JAMA Oncology
Volume: 7
Issue: 8
ISSN: 2374-2437
Publisher: American Medical Association  
Date Published: 2021-08-01
Start Page: 1167
End Page: 1175
Language: English
DOI: 10.1001/jamaoncol.2021.1799
PUBMED: 34137799
PROVIDER: scopus
PMCID: PMC8377563
DOI/URL:
Notes: Article -- Export Date: 1 September 2021 -- Source: Scopus
Altmetric
Citation Impact
MSK Authors