Convalescent plasma or plasma from vaccinated donors improved COVID-19 outcomes among patients with hematologic malignancy or immunosuppression, but was not effective for immune-competent, high-risk patients, according to the results of a prospective study presented at the EHA 2022 Hybrid Congress.
Previous studies indicate that convalescent plasma does not provide benefit to unselected patients with SARS-CoV-2 infection; however, retrospective data conversely suggest that patients with immunosuppression may benefit. The aim of this study was to determine if convalescent or vaccinated-donor plasma improved COVID-19 outcomes specifically among patients with hematologic disease or malignancy or who are otherwise immunosuppressed.
The study randomly assigned 133 patients with confirmed COVID-19 infection with oxygen saturation of 94% or less to receive convalescent or vaccinated plasma on day 1 and 2 or standard care. Patients had hematologic or solid cancer, were immunosuppressed due to disease or a treatment, or were at high risk for severe COVID-19, or were age 75 or older. Patients on mechanical ventilation were not included. The primary endpoint was time to improvement or alive at hospital discharge.
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Overall, there was a shorter time to improvement among patients who received plasma at a median of 12.5 days compared with 18 days among patients who received standard care, but this difference was not significant (hazard ratio [HR], 1.24; 95% CI, 0.83-1.85; P =.29).
There was a significant time to improvement among patients with hematologic or other cancers or immunosuppression with a median of 13 days compared with 32 days among patients in the standard care group (HR, 2.03; 95% CI, 1.17-3.6; P =.01). There was no difference in time to improvement among patients at high risk for severe COVID-19 or who were age 75 or older.
The rate of death among patients treated with plasma was lower at 18.2% compared with 28.6% among patients who received standard care in the hematologic or other malignancy and immunosuppressed groups. The rates were similar regardless of treatment with plasma or standard of care among patients who were at high risk or age 75 or older at 18.8% and 16.7%, respectively.
Patients treated with vaccinated plasma demonstrated a shorter time to improvement than patients treated with convalescent plasma in a sensitivity analysis, with a median of 10 or 13 days, respectively.
The authors concluded that “plasma from convalescent and particularly vaccinated donors improved outcome of COVID-19 patients with an underlying hematological disease/cancer or other reasons of impaired immune response.”
Disclosures: Disclosures are not available for this presentation.
Reference
Müller-Tidow C, Janssen M, Schäkel U, et al. A randomized controlled clinical trial demonstrates that plasma from convalescent and vaccinated donors improves outcomes of COVID-19 in patients with hematological disease, cancer or immunosuppression. Presented at EHA 2022; June 9-12, 2022. Abstract S282.
