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All Studies   Meta Analysis    Recent:   

Clinical features associated with COVID-19 outcome in multiple myeloma: first results from the International Myeloma Society data set

Chari et al., Blood, doi:10.1182/blood.2020008150
Dec 2020  
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Mortality 33% Improvement Relative Risk HCQ for COVID-19  Chari et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 502 patients in multiple countries Lower mortality with HCQ (not stat. sig., p=0.17) c19hcq.org Chari et al., Blood, December 2020 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
 
*, now with p < 0.00000000001 from 411 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 75 treatments. c19hcq.org
Retrospective multiple myeloma patients showing lower mortality with HCQ treatment, unadjusted RR 0.67, p = 0.17 (data is in the supplementary material).
Although the 33% lower mortality is not statistically significant, it is consistent with the significant 26% lower mortality [22‑30%] from meta analysis of the 249 mortality results to date.
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details.
risk of death, 33.1% lower, RR 0.67, p = 0.17, treatment 8 of 29 (27.6%), control 195 of 473 (41.2%), NNT 7.3.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Chari et al., 24 Dec 2020, retrospective, multiple countries, peer-reviewed, median age 69.0, 25 authors.
This PaperHCQAll
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
High but variable mortality for hospitalized MM patients (27% to 57%). l Uncontrolled MM in the setting of COVID-19 infection was associated with an increased risk of death. 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.
Footnotes For original data, please contact the International Myeloma Society at adminassistant@myelomasociety.org. The online version of this article contains a data supplement. The publication costs of this article were defrayed in part by page charge payment. Therefore, and solely to indicate this fact, this article is hereby marked "advertisement" in accordance with 18 USC section 1734.
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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. 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'additional', 'affiliation': [ { 'name': 'Center for Myeloma, New York Presbyterian Hospital-Weill Cornell ' 'Medical Center, New York, NY;'}]}, { 'ORCID': 'http://orcid.org/0000-0001-5392-9284', 'authenticated-orcid': False, 'given': 'Shaji', 'family': 'Kumar', 'sequence': 'additional', 'affiliation': [{'name': 'Division of Hematology, Mayo Clinic, Rochester, MN;'}]}, { 'given': 'Edward A.', 'family': 'Stadtmauer', 'sequence': 'additional', 'affiliation': [ { 'name': 'Abramson Cancer Center, University of Pennsylvania, ' 'Philadelphia, PA;'}]}, { 'given': 'Hermann', 'family': 'Einsele', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Internal Medicine II, University Hospital of ' 'Würzburg, Würzburg, Germany;'}]}, { 'ORCID': 'http://orcid.org/0000-0003-1797-8657', 'authenticated-orcid': False, 'given': 'Meral', 'family': 'Beksac', 'sequence': 'additional', 'affiliation': [{'name': 'Department of Hematology, Ankara University, Ankara, Turkey;'}]}, { 'given': 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'sequence': 'additional', 'affiliation': [ {'name': 'Clínica Universidad de Navarra and'}, { 'name': 'Centro de Investigacion Medica Aplicada (CIMA), Universidad de ' 'Navarra, Pamplona, Spain;'}, { 'name': 'Instituto de Investigacion Sanitaria de Navarra (IDISNA), ' 'Pamplona, Spain;'}, { 'name': 'Centro de Investigación Biomédica en Red de Cáncer (CIBER-ONC), ' 'Pamplona, Spain;'}]}, { 'given': 'Nikhil C.', 'family': 'Munshi', 'sequence': 'additional', 'affiliation': [ {'name': 'Dana-Farber Cancer Institute, Boston, MA;'}, { 'name': 'Department of Medical Oncology, Harvard Medical School, Boston, ' 'MA;'}, { 'name': 'US Department of Veterans Affairs (VA) Boston Healthcare System, ' 'Boston, MA; and'}]}, { 'given': 'Hervé', 'family': 'Avet-Loiseau', 'sequence': 'additional', 'affiliation': [ {'name': 'Intergroupe Francophone du Myélome (IFM), Paris, France;'}, { 'name': 'Centre de Recherche en Cancérologie de Toulouse, Unité 1037, ' 'INSERM, Toulouse, France'}]}], 'member': '234', 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multiple myeloma patients with ' 'COVID-19: lessons learned and the path forward', 'volume': '13', 'author': 'Wang', 'year': '2020', 'journal-title': 'J Hematol Oncol'}, { 'issue': '10', 'key': '2020122416310066200_B21', 'doi-asserted-by': 'crossref', 'first-page': '103', 'DOI': '10.1038/s41408-020-00372-5', 'article-title': 'Multiple myeloma and SARS-CoV-2 infection: clinical characteristics and ' 'prognostic factors of inpatient mortality', 'volume': '10', 'author': 'Martínez-López', 'year': '2020', 'journal-title': 'Blood Cancer J'}, { 'issue': '6500', 'key': '2020122416310066200_B22', 'doi-asserted-by': 'crossref', 'first-page': '208', 'DOI': '10.1126/science.abc3517', 'article-title': 'Estimating the burden of SARS-CoV-2 in France', 'volume': '369', 'author': 'Salje', 'year': '2020', 'journal-title': 'Science'}, { 'key': '2020122416310066200_B23', 'article-title': 'Dexamethasone in hospitalized patients with Covid-19: preliminary ' 'report [published online ahead of print 17 July 2020]', 'author': 'RECOVERY Collaborative Group', 'journal-title': 'N Engl J Med'}], 'container-title': 'Blood', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'http://ashpublications.org/blood/article-pdf/136/26/3033/1795491/bloodbld2020008150.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'syndication'}, { 'URL': 'http://ashpublications.org/blood/article-pdf/136/26/3033/1795491/bloodbld2020008150.pdf', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2020, 12, 24]], 'date-time': '2020-12-24T16:52:57Z', 'timestamp': 1608828777000}, 'score': 1, 'resource': { 'primary': { 'URL': 'https://ashpublications.org/blood/article/136/26/3033/474113/Clinical-features-associated-with-COVID-19-outcome'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2020, 12, 24]]}, 'references-count': 23, 'journal-issue': {'issue': '26', 'published-print': {'date-parts': [[2020, 12, 24]]}}, 'URL': 'http://dx.doi.org/10.1182/blood.2020008150', 'relation': {}, 'ISSN': ['0006-4971', '1528-0020'], 'subject': ['Cell Biology', 'Hematology', 'Immunology', 'Biochemistry'], 'published': {'date-parts': [[2020, 12, 24]]}}
Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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