Clinical features associated with COVID-19 outcome in multiple myeloma: first results from the International Myeloma Society data set
Ajai Chari, Mehmet Kemal Samur, Joaquin Martinez-Lopez, Gordon Cook, Noa Biran, Kwee Yong, Vania Hungria, Monika Engelhardt, Francesca Gay, Ana García Feria, Stefania Oliva, Rimke Oostvogels, Alessandro Gozzetti, Cara Rosenbaum, Shaji Kumar, Edward A Stadtmauer, Hermann Einsele, Meral Beksac, Katja Weisel, Kenneth C Anderson, María-Victoria Mateos, Philippe Moreau, Jesus San-Miguel, Nikhil C Munshi, Hervé Avet-Loiseau
The primary cause of morbidity and mortality in patients with multiple myeloma (MM) is an infection. Therefore, there is great concern about susceptibility to the outcome of COVID-19-infected patients with MM. This retrospective study describes the baseline characteristics and outcome data of COVID-19 infection in 650 patients with plasma cell disorders, collected by the International Myeloma Society to understand the initial challenges faced by myeloma patients during the COVID-19 pandemic.
Analyses were performed for hospitalized MM patients. Among hospitalized patients, the median age was 69 years, and nearly all patients (96%) had MM. Approximately 36% were recently diagnosed (2019-2020), and 54% of patients were receiving first-line therapy. Thirty-three percent of patients have died, with significant geographic variability, ranging from 27% to 57% of hospitalized patients.
Univariate analysis identified age, International Staging System stage 3 (ISS3), high-risk disease, renal disease, suboptimal myeloma control (active or progressive disease), and 1 or more comorbidities as risk factors for higher rates of death. Neither history of transplant, including within a year of COVID-19 diagnosis, nor other anti-MM treatments were associated with outcomes.
Multivariate analysis found that only age, high-risk MM, renal disease, and suboptimal MM control remained independent predictors of adverse outcome with COVID-19 infection. The management of MM in the era of COVID-19 requires careful consideration of patient- and disease-related factors to decrease the risk of acquiring COVID-19 infection, while not compromising disease control through appropriate MM treatment. This study provides initial data to develop recommendations for the management of MM patients with COVID-19 infection.
CITATION Blood. 2020 Dec 24;136(26):3033-3040. doi: 10.1182/blood.2020008150.