Lack of efficacy of convalescent plasma in COVID‐19 patients with concomitant hematological malignancies: An Italian retrospective study

Lanza, Francesco; Monaco, Federica; Ciceri, Fabio; Cairoli, Roberto; MV, Sacchi; Guidetti, Anna; Marchetti, Monia; Massaia, Massimo; Arcaini, Luca; Krampera, Mauro; Mohamed, Sara; Gherlinzoni, Filíppo; Mecucci, Christina; Gentile, Massimo; Romano, Ilaria; Venditti, Adriano; Ruggeri, M; D, Ferrero; Coviello, Elisa; Fabbri, E; Corradini, Paolo; Passamonti, Francesco

doi:10.1002/hon.3060

Cited by 13 publications

(13 citation statements)

References 48 publications

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“…Despite this, there is a high level of concordance among study outcomes, with a risk difference of -0.10, and a risk ratio of 0.63, which improve at -0.12 and 0.58, respectively, when the analysis is limited to RCTs (Figure 3). We note that several cohort studies, despite being defined as propensity-score matched 27 , did not match for concomitant antivirals (potentially masking CCP efficacy) or B-cell depleting agents. In sensitivity analysis, exclusion of individual studies did not affect significantly the effect size.…”

Section: Resultsmentioning

confidence: 99%

“…The literature search yielded 147 eligible studies, of which 9 controlled trials (4 randomized trials [20][21][22][23] and 5 cohort studies [24][25][26][27][28] ) were selected for meta-analysis, 13 uncontrolled large case series without individual patient data but totaling 358 patients were selected for descriptive analysis [29][30][31][32][33][34][35][36][37][38][39][40][41] , and 125 case reports/series totaling 265 patients met the eligibility criteria for individual patient data analysis, 35, . Reference 35 was included in both the descriptive analysis and the individual patient data analysis because individual patient data were available only for a subgroup of patients.…”

Section: Resultsmentioning

confidence: 99%

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COVID-19 convalescent plasma for the treatment of immunocompromised patients: a systematic review

Senefeld

Franchini

Mengoli

et al. 2022

Preprint

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Immunosuppressed patients have increased risk for morbidity and mortality from COVID-19 because they less frequently mount antibody responses to vaccines and often cannot tolerate small-molecule antivirals. The Omicron variant of concern of SARS-CoV-2 has progressively defeated anti-Spike mAbs authorized so far, paving the way to a return to COVID-19 convalescent plasma (CCP) therapy. In this systematic review we performed a metanalysis of 6 controlled studies (including 2 randomized controlled trials; totaling 368 treated patients and 1119 control), an individual patient data analysis of 125 case reports/series (totaling 265 patients), and a descriptive analysis of 13 uncontrolled large case series without individual patient data available (totaling 358 patients). The metanalysis showed a risk ratio for mortality of 0.61 in treatment with CCP versus standard of care for immunosuppressed COVID-19 patients. On the basis of this evidence, we encourage initiation of high-titer CCP from vaccinees (hybrid plasma) in immunocompromised patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

COVID-19 convalescent plasma for the treatment of immunocompromised patients: a systematic review

Senefeld

Franchini

Mengoli

et al. 2022

Preprint

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“…The process of study selection is represented in the PRISMA flow diagram (Figure 1). Three randomized clinical trials (RCTs) [28][29][30] enrolling 214 participants and 5 matched cohort studies [31][32][33][34][35] enrolling 1560 participants were included in the meta-analysis. Descriptive and exploratory analyses were performed on uncontrolled studies.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

COVID-19 Convalescent Plasma for the Treatment of Immunocompromised Patients: A Systematic Review and Meta-analysis

et al. 2023

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ImportancePatients who are immunocompromised have increased risk for morbidity and mortality associated with coronavirus disease 2019 (COVID-19) because they less frequently mount antibody responses to vaccines. Although neutralizing anti-spike monoclonal-antibody treatment has been widely used to treat COVID-19, evolutions of SARS-CoV-2 have been associated with monoclonal antibody-resistant SARS-CoV-2 variants and greater virulence and transmissibility of SARS-CoV-2. Thus, the therapeutic use of COVID-19 convalescent plasma has increased on the presumption that such plasma contains potentially therapeutic antibodies to SARS-CoV-2 that can be passively transferred to the plasma recipient.ObjectiveTo assess the growing number of reports of clinical experiences of patients with COVID-19 who are immunocompromised and treated with specific neutralizing antibodies via COVID-19 convalescent plasma transfusion.Data SourcesOn August 12, 2022, a systematic search was performed for clinical studies of COVID-19 convalescent plasma use in patients who are immunocompromised.Study SelectionRandomized clinical trials, matched cohort studies, and case report or series on COVID-19 convalescent plasma use in patients who are immunocompromised were included. The electronic search yielded 462 unique records, of which 199 were considered for full-text screening.Data Extraction and SynthesisThe study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were extracted by 3 independent reviewers in duplicate and pooled.Main Outcomes and MeauresThe prespecified end point was all-cause mortality after COVID-19 convalescent plasma transfusion; exploratory subgroup analyses were performed based on putative factors associated with the potential mortality benefit of convalescent plasma.ResultsThis systematic review and meta-analysis included 3 randomized clinical trials enrolling 1487 participants and 5 controlled studies. Additionally, 125 case series or reports enrolling 265 participants and 13 uncontrolled large case series enrolling 358 participants were included. Separate meta-analyses, using models both stratified and pooled by study type (ie, randomized clinical trials and matched cohort studies), demonstrated that transfusion of COVID-19 convalescent plasma was associated with a decrease in mortality compared with the control cohort for the amalgam of both randomized clinical trials and matched cohort studies (risk ratio [RR], 0.63 [95% CI, 0.50-0.79]).Conclusions and RelevanceThese findings suggest that transfusion of COVID-19 convalescent plasma is associated with mortality benefit for patients who are immunocompromised and have COVID-19.

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“…We read with interest the recent article by Lanza et al., reporting no benefit in 30‐ and 90‐days mortality from COVID‐19 convalescent plasma (CCP) in a retrospective propensity score‐matched study in patients with hematological malignancies. 1 While we agree with the need for national retrospective studies to learn from our experiences during this pandemic, we caution against accepting negative results from studies with serious limitations, especially when they contradict other compelling studies that provide a cohesive body of data consistent with efficacy.…”

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confidence: 71%

Convalescent plasma in oncohematological patients

Focosi¹,

Franchini

Joyner

et al. 2022

Hematological Oncology

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We read with interest the recent article by Lanza et al., reporting no benefit in 30-and 90-days mortality from COVID-19 convalescent plasma (CCP) in a retrospective propensity score-matched study in patients with hematological malignancies. 1 While we agree with the need for national retrospective studies to learn from our experiences during this pandemic, we caution against accepting negative results from studies with serious limitations, especially when they contradict other compelling studies that provide a cohesive body of data consistent with efficacy. convalescent plasma, COVID-19, oncohematology, SARS-CoV-2 AUTHOR CONTRIBUTIONSDaniele Focosi wrote the first draft; Michael J. Joyner, MD, Jeffrey P Henderson and Arturo Casadevall revised the final version.

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Lack of efficacy of convalescent plasma in COVID‐19 patients with concomitant hematological malignancies: An Italian retrospective study

Cited by 13 publications

References 48 publications

COVID-19 convalescent plasma for the treatment of immunocompromised patients: a systematic review

COVID-19 convalescent plasma for the treatment of immunocompromised patients: a systematic review

COVID-19 Convalescent Plasma for the Treatment of Immunocompromised Patients: A Systematic Review and Meta-analysis

Convalescent plasma in oncohematological patients

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