|The following article features coverage from the American Society of Hematology 2020 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.|
Treatment of serious coronavirus disease 2019 (COVID-19) with convalescent plasma (CP) resulted in the recovery from COVID-19 of some patients in a small study, researchers reported at the virtual 62nd American Society of Hematology (ASH) Annual Meeting and Exposition. An even smaller subset of individuals from the study cohort had both COVID-19 and cancer, as well, and a portion of those participants appeared to benefit from CP treatment as well.
The limited data from the study underscore “a potential role for passive immunity in this disease,” Moayed Ibrahim, MD, of Tulane University in New Orleans, Louisiana, and presenter of the study, said.
Existing data from studies of CP for the treatment of COVID-19 have been mixed, and little is known about the role of CP in the treatment of COVID-19. The purpose of this study was to evaluate the outcomes of patients who were critically ill with COVID-19 and who were treated with CP. Some of these critically ill enrollees also had a hematological malignancy.
The single-arm feasibility study included 17 patients who were critically ill with COVID-19. Across all enrollees, 6 patients in the cohort had hematologic malignancies. Patients were treated with 1 unit of CP. Of the 17 study participants, 12 patients received CP by enrolling in a clinical trial, and 5 participants were treated by way of the FDA’s individual emergency investigational new drug (eIND) pathway to access. One patient developed a fever as a result of infusion with CP “that led to termination after administering 50% of the volume.” No treatment-related deaths or adverse events were observed in the remaining patients who received CP.
The primary endpoint was feasibility of infusion among patients with respiratory failure. Secondary endpoints included survival, timing of extubation, hospital or intensive care unit (ICU) mortality and length of stay, and changes in the World Health Organization (WHO) ordinal scale.
The mean age of patients in the cohort was 56 years (range, 24-81 years), and 58.8% of the individuals were male. In the analysis, 52.9% of participants were Black, 41.2% were White, and 5.9% were characterized as “other.” The mean time since diagnosis was 5 days, and the mean time from symptom onset was 12 days. The mean number of comorbidities was 3, and 35.3% of patients required intubation. A hematologic malignancy was present in 6 of 17 (35.3%) of the participants.
After CP infusion, the survival rate at hospital discharge was 83%, and at the time of overall follow-up, the survival rate was 75%. All 6 of the patients with hematologic malignancies were discharged alive. However, the 75% survival rate decreased to 65% after 2 of these patients with HMs died in home hospice care. Despite these 2 deaths in the HM group, Dr Ibrahim stated: “We think CP did have some role in their survival.”
The WHO ordinal score decreased significantly after CP infusion from a mean of 5 to a mean of 3 (P =.02).
Dr Ibrahim acknowledged that the results are limited by the concomitant administration of other potential COVID-19 treatments, including remdesivir, sarilumab, or dexamethasone.
However, he added, “while a randomized controlled clinical trial remains the gold standard, our limited data represent a signal that CP is safe and efficacious in COVID-19.”
Disclosures: Some of the presenters disclosed financial relationships with the pharmaceutical industry and/or the medical device industry. For a full list of disclosures, please refer to the presentation abstract.
Read more of Cancer Therapy Advisor‘s coverage of the ASH 2020 meeting by visiting the conference page.
Ibrahim M, Pal P, Niu A, et al. COVID-19 convalescent plasma decreased oxygen requirement and hospital stay in COVID-19 hospitalized patients including those with hematological malignancies: a report of 16 patients. Presented at: the 62nd American Society of Hematology (ASH) Annual Meeting and Exposition; December 5-9, 2020. Abstract 101.