Association of Convalescent Plasma Therapy With Survival in Patients With Hematologic Cancers and COVID-19
Authors: 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. Shah, Jeremy L. Warner, Balazs Halmos, Amit Verma, Benjamin A Gartrell, Sanjay Goel, Nitin Ohri, R Alejandro Sica, Astha Thakkar, Keith E Stockerl-Goldstein, Omar Butt, Jian L Campian, Mark A Fiala, Ryan Monahan, Alice Y Zhou, Pamela Bohachek, Daniel Mundt, Mitrianna Streckfuss, Eyob Tadesse, Philip E Lammers, Sanjay G Revankar, Orestis A Panagiotou, Pamela C Egan, Dimitrios Farmakiotis, Hina Khan, Adam J Olszewski, Arturo Loaiza-Bonilla, Salvatore A Del Prete, Anne H Angevine, Michael H Bar, KM Steve Lo, Jamie Stratton, Paul L Weinstein, Paolo F Caimi, Jill S Barnholtz-Sloan, Jorge A Garcia, John M Nakayama, Shilpa Gupta, Nathan A Pennell, Manmeet S Ahluwalia, Scott J Dawsey, Amanda Nizam, Christopher A Lemmon, Claire Hoppenot, Ang Li, Ziad Bakouny, Gabrielle Bouchard, Fiona J Busser, Jean M Conners, Catherine R Curran, George D Demetri, Antonio Giordano, Kaitlin Kelleher, Anju Nohria, Andrew Schmidt, Grace Shaw, Eliezer M Van Allen, Pier Vitale Nuzzo, Wenxin Xu, Rebecca L Zon, Tian Zhang, Susan Halabi, Gary H Lyman, Jerome J Graber, Petros Grivas, Ali Raza Khaki, Elizabeth T Loggers, Ryan C Lynch, Elizabeth S Nakasone, Michael T Schweizer, Lisa ML Tachiki, Shaveta Vinayak, Michael J Wagner, Albert Yeh, Na Tosha N Gatson, Sharad Goyal, Minh-Phuong Huynh-Le, Lori J Rosenstein, Jessica M Clement, Ahmad Daher, Mark E Dailey, Rawad Elias, Emily Hsu, Alvaro G Menendez, Joerg Rathmann, Oscar K Serrano, Asha Jayaraj, Shirish M Gadgeel, Jessica E Hawley, Dawn L Hershman, Melissa K Accordino, Divaya Bhutani, Gary K Schwartz, Daniel Y Reuben, Sarah Mushtaq, Eric H Bernicker, John Deeken, Danielle Shafer, Mark A Lewis, Terence D Rhodes, David M Gill, Clarke A Low, Sarah Nagle, Brandon Hayes-Lattin, Shannon McWeeney, Eneida R Nemecek, Howard A Zaren, Stephanie J Smith, Gayathri Nagaraj, Mojtaba Akhtari, Eric Lau, Mark E Reeves, Stephanie Berg,  Destry Elms, Alicia K Morgans, Firas H Wehbe, Jessica Altman, Michael Gurley, Mary F Mulcahy, Eric B Durbin, Amit A Kulkarni, Heather H Nelson, Surbhi Shah, Rachel P Rosovsky, Kerry Reynolds, Aditya Bardia, Genevieve Boland, Justin Gainor, Leyre Zubiri, Thorvardur R Halfdanarson, Tanios Bekaii-Saab, Aakash Desai, Ruben A Mesa, Mark Bonnen, Daruka Mahadevan, Amelie G Ramirez, Mary Salazar, Rimma Belenkaya, John Philip, Gregory J Riely, Bryan Faller, Rana R McKay, Archana Ajmera, Angelo Cabal, Justin A Shaya, Lisa B Weissmann, Chinmay Jani, James L Chen, Margaret E Gatti-Mays, Sachin R Jhawar, Maryam B Lustberg, Joshua D Palmer, Clement Pillainayagam, Daniel G Stover, Sarah Wall, Nicole O Williams, Vidhya Karivedu, Daniel Addison, Monika Joshi, Harry Menon, Marc A Rovito, Amro Elshoury, Salma K Jabbour, Mansi R Shah, Babar Bashir, Sana Z Mahmood, Christopher McNair, Vasil Mico, Andrea Verghese Rivera, Chaim Miller, Elwyn Cabebe, Michael J Glover, Alokkumar Jha, Lidia Schapira, Sumit A Shah, Julie Tsu-Yu Wu, Suki Subbiah, Barbara B Logan, Goetz Kloecker, Gilberto de Lima Lopes, Karen Russell, Brittany Stith, Melissa Smits, Natasha Edwin, David D Chism, Susie Owenby, Deborah B Doroshow, Matthew D Galsky, Huili Zhu, Julie C Fu, Alyson Fazio, Kanishka G Patel, Jonathan Riess, Daniel H Kwon, Vaibhav Kumar, Jessica Y Islam, William A Wood, Syed A Ahmad, Punita Grover, Shuchi Gulati, Jordan Kharofa, Michelle Marcum, Cathleen Park, Trisha M Wise-Draper, Daniel W Bowles, Christopher L Geiger, Rohit Bishnoi, Merry-Jennifer Markham, Chintan Shah, Jared D Acoba, Young Soo Rho, Lawrence E Feldman, Kent F Hoskins, Gerald Gantt, Mahir Khan, Ryan H Nguyen, Mary M Pasquinelli, Candice Schwartz, Neeta K Venepalli, Praveen Vikas , Anup Kasi, Leslie A Fecher, Christopher R Friese, Blanche H Mavromatis, Qamar U Zaman, Ragneel Bijjula, Alex Cheng, Elizabeth J Davis, Benjamin French, Erin A Gillaspie, Daniel J Hausrath, Cassandra Hennessy, Chih-Yuan Hsu, Douglas B Johnson, Xuanyi Li, Sonya A Reid, Brian I Rini, Yu Shyr, David A Slosky, Carmen C Solorzano, Matthew D Tucker, Karen Vega-Luna, Lucy L Wang, Kyle T Enriquez, Tianyi Sun, Theresa M Carducci, Matthew Puc, Susan Van Loon, Karen J Goldsmith, Robert L Rice, Wilhelmina D Cabalona, Christine Pilar, Briana Barrow McCollough, Prakash Peddi, Lane R Rosen, Mehmet A Bilen, Deepak Ravindranathan, Navid Hafez, Roy S Herbst, Patricia LoRusso, Tyler Masters, Catherine Stratton
Journal: JAMA Oncology (2021)

<h3>Importance</h3> 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. <h3>Objective</h3> 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. <h3>Design, Setting, and Participants</h3> 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. <h3>Exposures</h3> Convalescent plasma treatment at any time during hospitalization. <h3>Main Outcomes and Measures</h3> 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. <h3>Results</h3> 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). <h3>Conclusions and Relevance</h3> 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.