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 inLeukemia 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
LanguageEnglish
Published London Nature Publishing Group UK 01.04.2022
Nature Publishing Group
Springer Nature
Subjects
692/308/575
692/700/565/251
Antibodies, Viral
Blood pressure
Cancer
Cancer Research
CD20 antigen
Coronaviruses
COVID-19
COVID-19 - therapy
Critical Care Medicine
Hematology
Humans
Hypertension
Immune clearance
Immune response
Immune response (humoral)
Immune system
Immunization, Passive
Immunosuppression
Immunotherapy
Intensive
Internal Medicine
Life Sciences
Lymphocytes B
Malignancy
Medical treatment
Medicine
Medicine & Public Health
Monoclonal antibodies
Mortality
Neoplasms
Oncology
Patients
Propensity Score
SARS-CoV-2
Sensitivity analysis
Severe acute respiratory syndrome coronavirus 2
Subgroups
Survival
Tumors
Viral diseases
Online AccessGet full text
ISSN0887-6924
1476-5551
1476-5551
DOI10.1038/s41375-022-01511-6

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Abstract 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.
AbstractList 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.
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.
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.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.
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.
Author Levi, Laura I.
Besson, Caroline
Hueso, Thomas
Pirenne, France
Guemriche, Amina
Freymond, Nathalie
Lanoy, Emilie
Pacanowski, Jérôme
Meynard, Jean-Luc
Hermine, Olivier
Grabar, Sophie
Godron, Anne-Sophie
Idri, Salim
Gagneux-Brunon, Amandine
Lacombe, Karine
Tiberghien, Pierre
Gras, Emmanuelle
Lamure, Sylvain
Morel, Pascal
Surgers, Laure
Duléry, Rémy
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ContentType Journal Article
Copyright The Author(s), under exclusive licence to Springer Nature Limited 2022
2022. The Author(s), under exclusive licence to Springer Nature Limited.
The Author(s), under exclusive licence to Springer Nature Limited 2022.
Distributed under a Creative Commons Attribution 4.0 International License
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Issue 4
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Snippet Patients with hematological malignancy and COVID-19 display a high mortality rate. In such patients, immunosuppression due to underlying disease and previous...
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StartPage 1025
SubjectTerms 692/308/575
692/700/565/251
Antibodies, Viral
Blood pressure
Cancer
Cancer Research
CD20 antigen
Coronaviruses
COVID-19
COVID-19 - therapy
Critical Care Medicine
Hematology
Humans
Hypertension
Immune clearance
Immune response
Immune response (humoral)
Immune system
Immunization, Passive
Immunosuppression
Immunotherapy
Intensive
Internal Medicine
Life Sciences
Lymphocytes B
Malignancy
Medical treatment
Medicine
Medicine & Public Health
Monoclonal antibodies
Mortality
Neoplasms
Oncology
Patients
Propensity Score
SARS-CoV-2
Sensitivity analysis
Severe acute respiratory syndrome coronavirus 2
Subgroups
Survival
Tumors
Viral diseases
Title Convalescent plasma improves overall survival in patients with B-cell lymphoid malignancy and COVID-19: a longitudinal cohort and propensity score analysis
URI https://link.springer.com/article/10.1038/s41375-022-01511-6
https://www.ncbi.nlm.nih.gov/pubmed/35105946
https://www.proquest.com/docview/2646835244
https://www.proquest.com/docview/2624948947
https://hal.science/hal-03642648
https://pubmed.ncbi.nlm.nih.gov/PMC8805670
Volume 36
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