New study findings of patients with multiple myeloma (MM) in the early phase of the COVID-19 pandemic underscore the importance of continuing MM treatment and focusing on controlling disease burden for improved outcomes instead of delaying treatment.
These results were published in Clinical Lymphoma, Myeloma & Leukemia.
Writing of previous data indicating a high risk of morbidity and mortality for patients with MM who contract COVID-19, the researchers retrospectively analyzed data from 162 patients with COVID-19 who visited 2 myeloma centers between March and October 2020, before the availability of vaccinations but during the time of large-scale implementation of regular screening processes within institutions.
“Based on the emerging information early in the pandemic, institutions around the country initially implemented strict screening and testing protocols and modification of treatment pathways,” detailed the researchers. “This resulted in more options that can be safely administrated with minimal health care exposure in these high-risk MM patients. Our study showed that these screening and treatment protocols led to better outcomes and a decrease in morbidity and mortality associated with COVID-19 infection in MM patients.”
Although previous data have indicated a case fatality rate from 22% to 29% among patients with MM, the current study showed a lower case fatality rate of 6%, with deaths reported in 10 patients. The risk of mortality was heightened in older patients with lymphopenia based on multivariate analysis.
In univariate analysis, the risk of hospitalization was increased for patients with comorbidities such as hypertension, diabetes, chronic kidney disease (CKD), and hepatic dysfunction, similar to what has been reported in the general population. However, multivariate analysis showed that just CKD and hepatic dysfunction, as well as hypogammaglobinemia, significantly increased the risk of hospital admission in multivariate analysis.
The group found no relationship between prior lines of treatment, type of treatment, active treatment, or maintenance treatment and severity or outcomes associated with COVID-19 infection. The researchers added, “This finding reinforced the notion of safely continuing the MM therapies during the COVID-19 pandemic in patients without evidence of COVID-19 infection, with focusing on better control of MM disease burden for better overall outcomes rather than delaying the therapies for MM.”
“Interestingly prior autologous stem cell transplant [ASCT] was not associated with an elevated risk of severe COVID-19 infection that requires hospitalization, oxygenation, or elevated mortality risk,” the group also wrote, explaining that 77 patients were treated with ASCT, including 6 who received the procedure within 12 months of being infected. They noted that this finding is consistent with previous studies.
Ehsan H, Britt A, Voorhees PM, et al. Retrospective review of outcomes of multiple myeloma (MM) patients with COVID-19 infection (two-center study). Clin Lymphoma Myeloma Leuk. Published online January 18, 2023. doi:10.1016/j.clml.2023.01.006