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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