Convalescent plasma improves overall survival in patients with B-cell lymphoid malignancy and COVID-19: a longitudinal cohort and propensity score analysis

Patients with hematological malignancy and COVID-19 display a high mortality rate. In such patients, immunosuppression due to underlying disease and previous specific treatments impair humoral response, limiting viral clearance. Thus, COVID-19 convalescent plasma (CCP) therapy appears as a promising...

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Published in:Leukemia Vol. 36; no. 4; pp. 1025 - 1034
Main Authors: Hueso, Thomas, Godron, Anne-Sophie, Lanoy, Emilie, Pacanowski, Jérôme, Levi, Laura I, Gras, Emmanuelle, Surgers, Laure, Guemriche, Amina, Meynard, Jean-Luc, Pirenne, France, Idri, Salim, Tiberghien, Pierre, Morel, Pascal, Besson, Caroline, Duléry, Rémy, Lamure, Sylvain, Hermine, Olivier, Gagneux-Brunon, Amandine, Freymond, Nathalie, Grabar, Sophie, Lacombe, Karine
Format: Journal Article
Language:English
Published: England Nature Publishing Group 01.04.2022
Subjects:
Antibodies, Viral
Blood pressure
CD20 antigen
Coronaviruses
COVID-19
COVID-19 - therapy
Hematology
Humans
Hypertension
Immune clearance
Immune response
Immune response (humoral)
Immune system
Immunization, Passive
Immunosuppression
Immunotherapy
Lymphocytes B
Malignancy
Medical treatment
Monoclonal antibodies
Mortality
Neoplasms
Patients
Propensity Score
SARS-CoV-2
Sensitivity analysis
Severe acute respiratory syndrome coronavirus 2
Subgroups
Survival
Tumors
Viral diseases
ISSN:0887-6924, 1476-5551, 1476-5551
Online Access:Get full text
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Summary:Patients with hematological malignancy and COVID-19 display a high mortality rate. In such patients, immunosuppression due to underlying disease and previous specific treatments impair humoral response, limiting viral clearance. Thus, COVID-19 convalescent plasma (CCP) therapy appears as a promising approach through the transfer of neutralizing antibodies specific to SARS-CoV-2. We report the effect of CCP in a cohort of 112 patients with hematological malignancy and COVID-19 and a propensity score analysis on subgroups of patients with B-cell lymphoid disease treated (n = 81) or not (n = 120) with CCP between May 1, 2020 and April 1, 2021. The overall survival of the whole cohort was 65% (95% CI = 56-74.9) and 77.5% (95% CI = 68.5-87.7) for patients with B-cell neoplasm. Prior anti-CD20 monoclonal antibody therapy was associated with better overall survival, whereas age, high blood pressure, and COVID-19 severity were associated with a poor outcome. After an inverse probability of treatment weighting approach, we observed in anti-CD20-exposed patients with B-cell lymphoid disease a decreased mortality of 63% (95% CI = 31-80) in the CCP-treated group compared to the CCP-untreated subgroup, confirmed in the other sensitivity analyses. Convalescent plasma may be beneficial in COVID-19 patients with B-cell neoplasm who are unable to mount a humoral immune response.
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ISSN:0887-6924
1476-5551
1476-5551
DOI:10.1038/s41375-022-01511-6