In a retrospective cohort study reported in JAMA Oncology, Michael A. Thompson, MD, PhD, FASCO, and colleagues found that the use of convalescent plasma therapy was associated with improved 30-day mortality among patients with hematologic cancers hospitalized for COVID-19.
Study Details
The study used data from the COVID-19 and Cancer Consortium registry collected between March 17, 2020, and January 21, 2021, from patients with hematologic cancers who were hospitalized for COVID-19. The main outcome measure was 30-day all-cause mortality. Outcomes were compared between all patients who did vs did not receive convalescent plasma and in 1:1 propensity score–matched analyses.
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.— Michael A. Thompson, MD, PhD, FASCO, and colleagues
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Key Findings
A total of 966 patients were included in the analysis; of these, 143 received convalescent plasma therapy and 823 did not.
With a median follow-up of 30 days (interquartile range = 21–90 days), 223 patients (23.1%) died within 30 days of COVID-19 diagnosis. The mortality rate among convalescent plasma recipients (19/143 = 13.3%) was significantly lower than that among nonrecipients (204/823 = 24.8%) on crude analysis (hazard ratio [HR] = 0.47, 95% confidence interval [CI] = 0.30–0.76). The difference remained significant in multivariate analysis adjusting for potential confounding factors in the overall comparison (adjusted HR = 0.60, 95% confidence interval [CI] = 0.37–0.97, P = .03) and in the propensity score-matched analysis (HR = 0.52, 95% CI = 0.29–0.92, P = .03).
Among 338 patients admitted to the intensive care unit, the mortality rate was significantly lower in convalescent plasma recipients (12/76 = 15.8%) vs nonrecipients (123/262 = 46.9%) on crude analysis (HR = 0.26, 95% CI = 0.14–0.47). The difference remained significant in multivariate analysis (adjusted HR = 0.30, 95% CI = 0.16–0.56) and in propensity score–matched analysis (HR = 0.40, 95% CI = 0.20–0.80).
Among 227 patients requiring mechanical ventilatory support, the mortality rate was lower in convalescent plasma recipients (8/45 = 17.8%) vs nonrecipients (97/182 = 53.3%) on crude analysis (HR = 0.24, 95% CI = 0.16–0.49). The difference remained significant on multivariate analysis (HR = 0.23, 95% CI = 0.10–0.50) and in propensity score–matched analysis (HR = 0.32, 95% CI = 0.14–0.72).
The investigators concluded, “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.”
Jeremy L. Warner, MD, MS, of the Division of Hematology and Oncology, Vanderbilt University, is the corresponding author for the JAMA Oncology article.
Disclosure: The study was funded by the U.S. Department of Health and Human Services, National Cancer Institute, and others. For full disclosures of the study authors, visit jamanetwork.com.
