Convalescent Plasma Treatment Increases Odds of COVID-19 Survival Among Patients With Hematologic Malignancies

For patients with hematologic cancers who contract COVID-19, receiving convalescent plasma may increase the odds of survival, according to a new study.

The study included over 900 patients with hematologic cancers, including leukemia, lymphoma, and multiple myeloma, who were hospitalized with COVID-19, revealing that giving patients plasma from people who have recovered from the virus improved the rate of 30-day mortality by 40% (hazard ratio [HR], 0.60; 95% CI: 0.37-0.97).

There were 223 (23.1%) deaths that occurred within 30 days, with convalescent plasma recipients having nearly half the crude mortality rate as patients who did not receive the treatment (13.3% vs 24.8%).

“These results suggest that convalescent plasma may not only help COVID-19 patients with blood cancers whose immune systems are compromised, it may also help patients with other illnesses who have weakened antibody responses to this virus or to the vaccines,” Jeffrey P. Henderson, MD, PhD, associate professor of medicine and of molecular microbiology at Washington University, said in a statement. “The data also emphasize the value of an antibody therapy such as convalescent plasma as a virus-directed treatment option for hospitalized COVID-19 patients.”

There were 338 patients who were admitted to the intensive care unit (ICU) throughout the study period, with those receiving convalescent plasma having higher rates of survival. These patients had a 60% reduced risk of death compared with patients admitted to the ICU who did not receive the plasma treatment (HR, 0.40; 95% CI: 0.20-0.80). Patients receiving the convalescent plasma had a mortality rate of 15.8% compared with 46.9% among nonrecipients.

Similar findings were shown among the 227 patients who required mechanical ventilation during hospitalization, with convalescent plasma recipients having a 73% reduced risk of death compared with nonrecipients.

“Notably, despite superior survival in the convalescent plasma group, there were considerably more sepsis and respiratory complications in this group,” highlighted the researchers. “This finding likely reflects a higher severity of SARS-CoV-2 infection rather than complications from the treatment, although this possibility cannot be entirely excluded. Adverse effects of protein-rich infusions can include thromboses, kidney injury, and volume overload.”

The researchers noted that the low rates of thromboses in both groups and similar rates of acute kidney injury were reassuring. They also added that while the rates were low, congestive heart failure was more frequent in patients who received convalescent plasma, warranting additional scrutiny in larger cohorts.

Reference

Thompson M, Henderson J, Shah P, et al. Association of convalescent plasma therapy with survival in patients with hematologic cancers and COVID-19. JAMA Oncol. Published online June 17, 2021. doi:10.1001/jamaoncol.2021.1799