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Treatment of chronic COVID-19 with convalescent/postvaccination plasma in patients with hematologic malignancies

Immunocompromised patients are at high risk to fail clearance of SARS-CoV-2. Prolonged COVID-19 constitutes a health risk and a management problem as cancer treatments often have to be disrupted. As SARS-CoV-2 evolves, new variants of concern have emerged that evade available monoclonal antibodies....

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Main Authors: Janssen, Maike (Author) , Leo, Albrecht (Author) , Wolf, Cornelia (Author) , Stenzinger, Miriam (Author) , Bartenschlager, Marie (Author) , Brandt, Juliane (Author) , Sauer, Sandra (Author) , Schmitt, Michael (Author) , Dreger, Peter (Author) , Schlenk, Richard Friedrich (Author) , Denkinger, Claudia M. (Author) , Müller-Tidow, Carsten (Author)
Format: Article (Journal)
Language:English
Published: 9 May 2024
In: International journal of cancer
Year: 2024, Volume: 155, Issue: 4, Pages: 618-626
ISSN:1097-0215
DOI:10.1002/ijc.34988
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1002/ijc.34988
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Author Notes:Maike Janssen, Albrecht Leo, Cornelia Wolf, Miriam Stenzinger, Marie Bartenschlager, Juliane Brandt, Sandra Sauer, Michael Schmitt, Peter Dreger, Richard F. Schlenk, Claudia M. Denkinger, Carsten Müller-Tidow
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Summary:Immunocompromised patients are at high risk to fail clearance of SARS-CoV-2. Prolonged COVID-19 constitutes a health risk and a management problem as cancer treatments often have to be disrupted. As SARS-CoV-2 evolves, new variants of concern have emerged that evade available monoclonal antibodies. Moreover, antiviral therapy promotes SARS-CoV-2 escape mutations, particularly in immunocompromised patients. These patients frequently suffer from prolonged infection. No successful treatment has been established for persistent COVID-19 infection. Here, we report on a series of 21 immunocompromised patients with COVID-19-most of them hematologic malignancies-treated with plasma obtained from recently convalescent or vaccinated donors or a combination thereof. Repeated dosing of SARS-CoV-2-antibody-containing plasma could clear SARS-CoV-2 infection in 16 out of 21 immunocompromised patients even if COVID-19-specific treatments failed to induce sustained viral clearance or to improve clinical course of SARS-CoV-2 infection. Ten patients were major responders defined as an increase delta(d)Ct of > = 5 after the first administration of convalescent and/or vaccinated plasma (C/VP). On average, SARS-CoV-2 PCR Ct values increased from a median value of 22.55 (IQR = 19.10-24.25) to a median value of 29.57 (IQR = 27.55-34.63; p = <.0001) in the major response subgroup. Furthermore, when treated a second time with C/VP, even 4 out of 5 of the initial nonresponders showed an increase in Ct-values from a median value of 23.13 (IQR = 17.75-28.05) to a median value of 32.79 (IQR = 31.75-33.75; p = .013). Our results suggest that C/VP could be a feasible treatment of COVID-19 infection in patients with hematologic malignancies who did not respond to antiviral treatment.
Item Description:Gesehen am 18.03.2025
Physical Description:Online Resource
ISSN:1097-0215
DOI:10.1002/ijc.34988

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