Therapeutic Use of Convalescent Plasma in COVID-19 Infected Patients with Concomitant Hematological Disorders

Authors

Francesco Lanza^{1, *,} , Vanessa Agostini², Federica Monaco¹, Francesco Passamonti^3, , Jerard Seghatchian⁴

¹Hematology Unit & Romagna Transplant Network, Ravenna, Italy

²Transfusion Medicine Department, IRCCS- Ospedale Policlinico San Martino, Genova, Italy

³Hematology Unit, University of Insubria, Varese, Italy

⁴International Consultancy in Innovative Manufacturing and Quality/Safety of Blood-Derived Bioproducts, London, England, UK

^*Corresponding author. Email: francesco.lanza@auslromagna.it

DOI

10.2991/chi.k.210403.001How to use a DOI?

Keywords

SARS-CoV-2; COVID-19 antibodies; plasmapheresis; convalescent plasma preparations; hematological disorders; neutralising antibodies; prolonged viral shedding; COVID-19 mutation

Abstract

The use of convalescent plasma (CP) from individuals recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a promising therapeutic modality for the coronavirus disease 2019 (COVID-19). CP has been in use for at least a century to provide passive immunity against a number of diseases, and was recently proposed by the World Health Organization for human Ebola virus infection. Only a few small studies have so far been published on patients with COVID-19 and concomitant hematological malignancies (HM). The Italian Hematology Alliance on HM and COVID-19 has found that HM patients with COVID-19 clinically perform more poorly than those with either HM or COVID-19 alone. A COVID-19 infection in patients with B-cell lymphoma is associated with impaired generation of neutralizing antibody titers and lowered clearance of SARS-CoV-2. Treatment with CP was seen to increase antibody titers in all patients and to improve clinical response in 80% of patients examined. However, a recent study has reported impaired production of SARS-CoV-2-neutralizing antibodies in an immunosuppressed individual treated with CP, possibly supporting the notion of virus escape, particularly in immunocompromised individuals where prolonged viral replication occurs. This may limit the efficacy of CP treatment in at least some HM patients. More recently, it has been shown that CP may provide a neutralising effect against B.1.1.7 and other SARS-CoV-2 variants, thus expanding its application in clinical practice. More extensive studies are needed to further assess the use of CP in COVID-19-infected HM patients.

Copyright

© 2021 International Academy for Clinical Hematology. Publishing services by Atlantis Press International B.V.

Open Access

This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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TY  - JOUR
AU  - Francesco Lanza
AU  - Vanessa Agostini
AU  - Federica Monaco
AU  - Francesco Passamonti
AU  - Jerard Seghatchian
PY  - 2021
DA  - 2021/04/16
TI  - Therapeutic Use of Convalescent Plasma in COVID-19 Infected Patients with Concomitant Hematological Disorders
JO  - Clinical Hematology International
SP  - 77
EP  - 82
VL  - 3
IS  - 3
SN  - 2590-0048
UR  - https://doi.org/10.2991/chi.k.210403.001
DO  - 10.2991/chi.k.210403.001
ID  - Lanza2021
ER  -