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Multiple Myeloma and SARS-CoV-2 Infection: Clinical Characteristics and Prognostic Factors of Inpatient Mortality

Martinez-Lopez et al., Blood Cancer Journal, doi:10.1038/s41408-020-00372-5
Jun 2020  
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Mortality 33% Improvement Relative Risk HCQ  Martinez-Lopez et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 167 patients in Spain Lower mortality with HCQ (not stat. sig., p=0.2) c19hcq.org Martinez-Lopez et al., Blood Cancer J., Jun 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 419 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19hcq.org
Retrospective 167 multiple myeloma patients in Spain, showing no significant difference in mortality with HCQ treatment in unadjusted results without group details.
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 253 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, 33.0% lower, RR 0.67, p = 0.20, treatment 47 of 148 (31.8%), control 9 of 19 (47.4%), NNT 6.4.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Martinez-Lopez et al., 30 Jun 2020, retrospective, Spain, peer-reviewed, median age 71.0, 25 authors.
This PaperHCQAll
Multiple myeloma and SARS-CoV-2 infection: clinical characteristics and prognostic factors of inpatient mortality
Joaquín Martínez-López, María-Victoria Mateos, Cristina Encinas, Anna Sureda, José Ángel Hernández-Rivas, Ana Lopez De La Guía, Diego Conde, Isabel Krsnik, Elena Prieto, Rosalía Riaza Grau, Mercedes Gironella, María Jesús Blanchard, Nerea Caminos, Carlos Fernández De Larrea, María Alicia Senin, Fernando Escalante, José Enrique De La Puerta, Eugenio Giménez, Pilar Martínez-Barranco, Juan José Mateos, Luis Felipe Casado, Joan Bladé, Juan José Lahuerta, Javier De La Cruz, Jesús San-Miguel
Blood Cancer Journal, doi:10.1038/s41408-020-00372-5
There is limited information on the characteristics, prognostic factors, and outcomes of patients with multiple myeloma (MM) hospitalized with COVID-19. This retrospective case series investigated 167 patients reported from 73 hospitals within the Spanish Myeloma Collaborative Group network in March and April, 2020. Outcomes were compared with 167 randomly selected, contemporary, age-/sex-matched noncancer patients with COVID-19 admitted at six participating hospitals. Among MM and noncancer patients, median age was 71 years, and 57% of patients were male; 75 and 77% of patients, respectively, had at least one comorbidity. COVID-19 clinical severity was moderate-severe in 77 and 89% of patients and critical in 8 and 4%, respectively. Supplemental oxygen was required by 47 and 55% of MM and noncancer patients, respectively, and 21%/9% vs 8%/6% required noninvasive/invasive ventilation. Inpatient mortality was 34 and 23% in MM and noncancer patients, respectively. Among MM patients, inpatient mortality was 41% in males, 42% in patients aged >65 years, 49% in patients with active/progressive MM at hospitalization, and 59% in patients with comorbid renal disease at hospitalization, which were independent prognostic factors on adjusted multivariate analysis. This case series demonstrates the increased risk and identifies predictors of inpatient mortality among MM patients hospitalized with COVID-19.
Conflict of interest M.-V.M. has received honoraria for lectures and participation in advisory boards from Janssen, Celgene-BMS, Amgen, Takeda, Abbvie, GSK, Adaptive, Roche, Seatle Genetics, Pfizer, and Regeneron. J.M.-L. has received honoraria for participation in advisory boards from Novartis, Roche, BMS, Adaptive, Incyte, Amgen, and Janssen-Cilag. J.S.-M. has received honoraria for lectures and advisory boards from Amgen, Bristol-Myers Squibb, Celgene, Janssen, Merck, Novartis, Takeda, Sanofi, and Roche. J.B. has received honoraria for lectures and advisory boards from Janssen, Celgene, Amgen, Takeda, and Oncopeptides. J.J.L. has received honoraria for lectures and advisory boards from Janssen, Celgene, Amgen, and Takeda. A.L. has received honoraria for advisory boards from Celgene, Amgen, and Janssen. P.M.-B. has received honoraria for advisory boards from Amgen. A.S. has received honoraria for advisory boards from Takeda, BMS, MSD, Sanofi, Roche, Novartis, Janssen, and Sandoz, and for a consultancy from Takeda, BMS, Novartis, Celgene, Janssen, Gilead, and Sanofi, and has received honoraria as a member of a Speakers Bureau for Takeda. F.E. has received honoraria for advisory boards from Celgene and Amgen. E.P.P. has received honoraria for advisory boards from Amgen and for lectures from BMS/Celgene and Janssen. C.F.d.L. has received honoraria for advisory boards from BMS/Celgene, Amgen, Takeda, and Janssen. L.F.C. reports honoraria for lectures from and membership on..
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Kidney Int. 97, 829–838 (2020).', 'journal-title': 'Kidney Int.'}], 'container-title': 'Blood Cancer Journal', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://www.nature.com/articles/s41408-020-00372-5.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://www.nature.com/articles/s41408-020-00372-5', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://www.nature.com/articles/s41408-020-00372-5.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2022, 12, 5]], 'date-time': '2022-12-05T14:35:57Z', 'timestamp': 1670250957000}, 'score': 1, 'resource': {'primary': {'URL': 'https://www.nature.com/articles/s41408-020-00372-5'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2020, 10, 19]]}, 'references-count': 28, 'journal-issue': {'issue': '10', 'published-online': {'date-parts': [[2020, 10]]}}, 'alternative-id': ['372'], 'URL': 'http://dx.doi.org/10.1038/s41408-020-00372-5', 'relation': { 'has-preprint': [ { 'id-type': 'doi', 'id': '10.1101/2020.06.29.20142455', 'asserted-by': 'object'}]}, 'ISSN': ['2044-5385'], 'subject': ['Oncology', 'Hematology'], 'container-title-short': 'Blood Cancer J.', 'published': {'date-parts': [[2020, 10, 19]]}, 'assertion': [ { 'value': '31 July 2020', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '6 August 2020', 'order': 2, 'name': 'revised', 'label': 'Revised', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '6 August 2020', 'order': 3, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '19 October 2020', 'order': 4, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': 'M.-V.M. has received honoraria for lectures and participation in advisory ' 'boards from Janssen, Celgene-BMS, Amgen, Takeda, Abbvie, GSK, Adaptive, Roche, ' 'Seatle Genetics, Pfizer, and Regeneron. J.M.-L. has received honoraria for ' 'participation in advisory boards from Novartis, Roche, BMS, Adaptive, Incyte, ' 'Amgen, and Janssen-Cilag. J.S.-M. has received honoraria for lectures and ' 'advisory boards from Amgen, Bristol–Myers Squibb, Celgene, Janssen, Merck, ' 'Novartis, Takeda, Sanofi, and Roche. J.B. has received honoraria for lectures ' 'and advisory boards from Janssen, Celgene, Amgen, Takeda, and Oncopeptides. ' 'J.J.L. has received honoraria for lectures and advisory boards from Janssen, ' 'Celgene, Amgen, and Takeda. A.L. has received honoraria for advisory boards ' 'from Celgene, Amgen, and Janssen. P.M.-B. has received honoraria for advisory ' 'boards from Amgen. A.S. has received honoraria for advisory boards from Takeda, ' 'BMS, MSD, Sanofi, Roche, Novartis, Janssen, and Sandoz, and for a consultancy ' 'from Takeda, BMS, Novartis, Celgene, Janssen, Gilead, and Sanofi, and has ' 'received honoraria as a member of a Speakers Bureau for Takeda. F.E. has ' 'received honoraria for advisory boards from Celgene and Amgen. E.P.P. has ' 'received honoraria for advisory boards from Amgen and for lectures from ' 'BMS/Celgene and Janssen. C.F.d.L. has received honoraria for advisory boards ' 'from BMS/Celgene, Amgen, Takeda, and Janssen. L.F.C. reports honoraria for ' 'lectures from and membership on advisory boards with Celgene, Janssen, Roche, ' 'Novartis, Bristol–Myers Squibb, Amgen, Takeda, Pfizer, Incyte, and AbbVie. The ' 'remaining authors declare that they have no conflict of interest.', 'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Conflict of interest'}}], 'article-number': '103'}
Late treatment
is less effective
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