Patients with malignancy are particularly vulnerable to infection with Severe Acute Respiratory Disease-Coronavirus-2 (SARS-CoV-2) given their immunodeficiency secondary to their underlying disease and cancer-directed therapy. We report a case series of patients with cancer who received convalescent plasma, an investigational therapy for severe Coronavirus Disease 2019 (COVID-19).
Patients with cancer were identified who received convalescent plasma. Enrolled patients had confirmed COVID-19 with severe or life-threatening disease and were transfused with convalescent plasma from donors with a SARS-CoV-2 anti-spike antibody titer of ≥ 1:320 dilution. Oxygen requirements and clinical outcomes of interests were captured as well as laboratory parameters at baseline and 3 days after treatment.
We identified 24 patients with cancer, 14 of whom had a hematological malignancy, who were treated with convalescent plasma. Fifteen patients (62.5%) were on cancer-directed treatment at the time of COVID-19 infection. After a median of hospital duration of 9 days, 13 patients (54.2%) had been discharged home, 1 patient (4.2%) was still hospitalized, and 10 patients had died (41.7%). Non-intubated patients, particularly those on nasal cannula alone, had favorable outcomes. Three mild febrile non-hemolytic transfusion reactions were observed. C-reactive protein significantly decreased after 3 days of treatment, while other laboratory parameters including ferritin and D-dimer remained unchanged.
Convalescent plasma may be a promising therapy in cancer patients with COVID-19.
Cancer medicine. 2020 Sep 17 [Epub ahead of print]
Douglas Tremblay, Carina Seah, Thomas Schneider, Sheena Bhalla, Jonathan Feld, Leonard Naymagon, Bo Wang, Vaibhav Patel, Tomi Jun, Thomas Jandl, Farah Rahman, Sean T H Liu, Judith A Aberg, Nicole Bouvier, Mount Sinai Health System Convalescent Plasma Team
Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, NY, USA., Graduate School of Biomedical Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.