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

Clinical Hematology International Pub Date : 2021-04-16 eCollection Date: 2021-09-01 DOI:10.2991/chi.k.210403.001
Francesco Lanza, Vanessa Agostini, Federica Monaco, Francesco Passamonti, Jerard Seghatchian
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引用次数: 7

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.

Abstract Image

恢复期血浆在新冠肺炎合并血液病患者中的治疗应用
使用严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)患者的恢复期血浆(CP)是2019年冠状病毒病(COVID-19)的一种有希望的治疗方式。CP已经被使用了至少一个世纪,用于提供对许多疾病的被动免疫,最近被世界卫生组织提出用于人类埃博拉病毒感染。迄今为止,仅发表了几项针对COVID-19患者和伴发血液恶性肿瘤(HM)的小型研究。意大利HM和COVID-19血液学联盟发现,合并COVID-19的HM患者的临床表现比单独患有HM或COVID-19的患者更差。b细胞淋巴瘤患者的COVID-19感染与中和抗体滴度产生受损和SARS-CoV-2清除率降低相关。用CP治疗可以提高所有患者的抗体滴度,并改善80%患者的临床反应。然而,最近的一项研究报告称,在接受CP治疗的免疫抑制个体中,sars - cov -2中和抗体的产生受损,这可能支持病毒逃逸的概念,特别是在发生长时间病毒复制的免疫功能低下个体中。这可能会限制CP治疗至少在一些HM患者的疗效。最近,研究表明,CP可能对B.1.1.7和其他SARS-CoV-2变体具有中和作用,从而扩大了其在临床实践中的应用。需要更广泛的研究来进一步评估CP在covid -19感染的HM患者中的使用情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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