TY - JOUR
T1 - Association of Convalescent Plasma Therapy with Survival in Patients with Hematologic Cancers and COVID-19
AU - Thompson, Michael A.
AU - Henderson, Jeffrey P.
AU - Shah, Pankil K.
AU - Rubinstein, Samuel M.
AU - Joyner, Michael J.
AU - Choueiri, Toni K.
AU - Flora, Daniel B.
AU - Griffiths, Elizabeth A.
AU - Gulati, Anthony P.
AU - Hwang, Clara
AU - Koshkin, Vadim S.
AU - Papadopoulos, Esperanza B.
AU - Robilotti, Elizabeth V.
AU - Su, Christopher T.
AU - Wulff-Burchfield, Elizabeth M.
AU - Xie, Zhuoer
AU - Yu, Peter Paul
AU - Mishra, Sanjay
AU - Senefeld, Jonathon W.
AU - Shah, Dimpy P.
AU - Warner, Jeremy L.
N1 - Funding Information:
whole or in part with federal funds from the US Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response, Biomedical Advanced Research and Development Authority under contract 75A50120C00096 (Drs Joyner, P. Shah, and D. P. Shah); National Cancer Institute grants P30 CA008748 (Drs Robilloti and Papadopolous), P30 CA046592 (Dr Su), P30 CA054174 (Drs P. Shah and D. P. Shah), P30 CA068485 (Drs Warner and Mishra), T32 CA236621 (Dr Su), and U01 CA231840 (Dr Warner); National Center for Advancing Translational Sciences grant UL1 TR002377
Funding Information:
Funding/Support: This project has been funded in
Funding Information:
Author Contributions: Dr Warner had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Drs Thompson and Henderson contributed equally. Drs D. P. Shah and Warner contributed equally Concept and design: Thompson, Henderson, Rubinstein, Joyner, Choueiri, Xie, D. P. Shah, Warner. Acquisition, analysis, or interpretation of data: Thompson, Henderson, P. Shah, Rubinstein, Choueiri, Flora, Griffiths, Gulati, Hwang, Koshkin, Papadopoulos, Robilotti, Su, Wulff-Burchfield, Xie, Yu, Mishra, Senefeld, D. P. Shah, Warner. Drafting of the manuscript: Thompson, Henderson, P. Shah, Rubinstein, Joyner, Griffiths, Xie, Yu, D. P. Shah, Warner. Critical revision of the manuscript for important intellectual content: Thompson, Henderson, Rubinstein, Choueiri, Flora, Griffiths, Gulati, Hwang, Koshkin, Papadopoulos, Robilotti, Su, Wulff-Burchfield, Xie, Yu, Mishra, Senefeld, D. P. Shah, Warner. Statistical analysis: P. Shah, D. P. Shah. Obtained funding: Henderson, Warner. Administrative, technical, or material support: Thompson, Joyner, Choueiri, Flora, Griffiths, Hwang, Koshkin, Wulff-Burchfield, Yu, Mishra. Supervision: Thompson, Henderson, Choueiri, Senefeld, D. P. Shah, Warner. Conflict of Interest Disclosures: Dr Thompson reported receiving personal fees from Adaptive, BMS, Elsevier, Epizyme, Takeda, and AIM Specialty Health, royalties from UpToDate, personal fees from GRAIL/Illumina, and nonfinancial support (travel) from Syapse outside the submitted work. Dr Henderson reported receiving personal fees from Immunome outside the submitted work. Dr P. Shah reported receiving grants from the Biomedical Advanced Research and Development Authority during the conduct of the study. Dr Choueiri reported receiving nonfinancial support from the COVID-19 and Cancer Consortium, the European Society of Medical Oncology COVID-19 Registry for Patients With Cancer, and the COVID-19 and Cancer Outcomes Study during the conduct of the study and receiving honoraria from Pfizer, Exelixis, BMS, Merck, Roche/Genentech, Novartis, and Lilly and royalties for UpToDate outside the submitted work. Dr Griffiths reported receiving personal fees from Takeda Oncology, AbbVie, Novartis Pharmaceuticals, Celgene/BMS, Alexion Pharmaceuticals, and Boston Biomedical, nonfinancial support from Appelis Pharmaceuticals, and grants from Genentech outside the submitted work. Dr Hwang reported receiving grants from Merck, Exelixis, Bayer, AstraZeneca, Genentech, Dendreon, and Bausch, personal fees from Sanofi/ Genzyme, Exelixis, Bristol Myers Squibb, Astellas, Medivation, Bayer, and Janssen Scientific, and owning stock in Johnson and Johnson outside the submitted work. Dr Koshkin reported receiving personal fees from AstraZeneca, Clovis, Janssen, Pfizer, EMD Serono, Seattle Genetics/Astellas, and Dendreon and grants from Endocyte, Nektar, Clovis, Taiho, and Janssen outside the submitted work. Dr Wulff-Burchfield reported receiving personal fees from Exelixis, BMS Consulting, and Pfizer Global and having a family member with stock ownership in Immunomedics and Nektar outside the submitted work. Dr Mishra reported receiving grants from the National Cancer Institute during the conduct of the study. Dr Senefeld reported having a contract with the Biomedical Advanced Research and Development Authority during the conduct of the study. Dr D. P. Shah reported receiving grants from the Biomedical Advanced Research and Development Authority, American Cancer Society, and Hope Foundation for Cancer Research during the conduct of the study. Dr Warner reported receiving grants from the National Cancer Institute during the conduct of the study, nonfinancial support from HemOnc.org LLC, and personal fees from Westat and IBM Watson Oncology outside the submitted work. No other disclosures were reported.
Publisher Copyright:
© 2021 American Medical Association. All rights reserved.
PY - 2021/8
Y1 - 2021/8
N2 - Importance: 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. Objective: 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. Design, Setting, and Participants: 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. Exposures: Convalescent plasma treatment at any time during hospitalization. Main Outcomes and Measures: 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. Results: 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). Conclusions and Relevance: 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.
AB - Importance: 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. Objective: 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. Design, Setting, and Participants: 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. Exposures: Convalescent plasma treatment at any time during hospitalization. Main Outcomes and Measures: 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. Results: 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). Conclusions and Relevance: 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.
UR - http://www.scopus.com/inward/record.url?scp=85108541368&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85108541368&partnerID=8YFLogxK
U2 - 10.1001/jamaoncol.2021.1799
DO - 10.1001/jamaoncol.2021.1799
M3 - Article
C2 - 34137799
AN - SCOPUS:85108541368
SN - 2374-2437
VL - 7
SP - 1167
EP - 1175
JO - JAMA oncology
JF - JAMA oncology
IS - 8
ER -