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Cancer Med
. 2020 Sep 17.
doi: 10.1002/cam4.3457. Online ahead of print.
Convalescent Plasma for the Treatment of Severe COVID-19 Infection in Cancer Patients
Douglas Tremblay 1 , Carina Seah 2 , Thomas Schneider 3 , Sheena Bhalla 1 , Jonathan Feld 1 , Leonard Naymagon 1 , Bo Wang 1 , Vaibhav Patel 1 , Tomi Jun 1 , Thomas Jandl 1 , Farah Rahman 4 , Sean T H Liu 4 , Judith A Aberg 4 , Nicole Bouvier 4 , Mount Sinai Health System Convalescent Plasma Team
Affiliations
- PMID: 32945149
- DOI: 10.1002/cam4.3457
Abstract
Background: Patients with malignancy are particularly vulnerable to infection with Severe Acute Respiratory Disease-Coronavirus-2 (SARS-CoV-2) given their immunodeficiency secondary to their underlying disease and cancer-directed therapy. We report a case series of patients with cancer who received convalescent plasma, an investigational therapy for severe Coronavirus Disease 2019 (COVID-19).
Methods: Patients with cancer were identified who received convalescent plasma. Enrolled patients had confirmed COVID-19 with severe or life-threatening disease and were transfused with convalescent plasma from donors with a SARS-CoV-2 anti-spike antibody titer of ≥ 1:320 dilution. Oxygen requirements and clinical outcomes of interests were captured as well as laboratory parameters at baseline and 3 days after treatment.
Results: We identified 24 patients with cancer, 14 of whom had a hematological malignancy, who were treated with convalescent plasma. Fifteen patients (62.5%) were on cancer-directed treatment at the time of COVID-19 infection. After a median of hospital duration of 9 days, 13 patients (54.2%) had been discharged home, 1 patient (4.2%) was still hospitalized, and 10 patients had died (41.7%). Non-intubated patients, particularly those on nasal cannula alone, had favorable outcomes. Three mild febrile non-hemolytic transfusion reactions were observed. C-reactive protein significantly decreased after 3 days of treatment, while other laboratory parameters including ferritin and D-dimer remained unchanged.
Conclusions: Convalescent plasma may be a promising therapy in cancer patients with COVID-19.
Keywords: COVID-19; SARS-CoV-2; cancer; convalescent plasma; malignancy.