Convalescent Plasma for the Treatment of Severe COVID-19 Infection in Cancer Patients

Cancer Med. 2020 Nov;9(22):8571-8578. doi: 10.1002/cam4.3457. Epub 2020 Sep 17.


Background: 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).

Methods: 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.

Results: 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.

Conclusions: Convalescent plasma may be a promising therapy in cancer patients with COVID-19.

Keywords: COVID-19; SARS-CoV-2; cancer; convalescent plasma; malignancy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Betacoronavirus / isolation & purification*
  • COVID-19
  • COVID-19 Serotherapy
  • Coronavirus Infections / complications*
  • Coronavirus Infections / therapy
  • Coronavirus Infections / transmission
  • Coronavirus Infections / virology
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Immunization, Passive
  • Male
  • Middle Aged
  • Neoplasms / epidemiology
  • Neoplasms / therapy*
  • Neoplasms / virology
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / therapy
  • Pneumonia, Viral / transmission
  • Pneumonia, Viral / virology
  • Prognosis
  • Risk Factors
  • SARS-CoV-2
  • Severity of Illness Index*
  • Survival Rate
  • United States / epidemiology