Patients with hematologic malignancies, including multiple myeloma (MM), have more severe reactions to COVID-19 compared with patients with solid tumors, according to a study published in The Lancet Oncology.
The study included a cohort of 1,044 adults with cancer who were enrolled in the UK Coronavirus Cancer Monitoring Project (UKCCMP) between March 18, 2020, and May 8, 2020. These patients were compared with a parallel control population of 282,878 U.K. patients with cancer who did not have COVID-19 who were identified via 2017 data from the UK Office for National Statistics. Researchers assessed the effect of tumor subtype and patient demographics on prevalence and mortality from COVID-19.
A total of 319 patients (30.6%) in the UKCCMP cohort died, 295 (92.5%) of whom had a cause of death related to COVID-19. The all-cause case fatality rate in patients with cancer after SARS-CoV-2 infection was significantly associated with increasing age, increasing from 0.10 in patients aged 40 to 49 years to 0.48 in those aged 80 years and older.
Patients with hematologic malignancies (including leukemia, lymphoma, and MM) had a more severe COVID-19 trajectory compared with patients with solid tumors (odds ratio [OR], 1.57; 95% confidence interval [CI], 1.15-2.15; P<0.0043).
After accounting for age and sex, patients with hematologic malignancies who recently received chemotherapy were at an increased risk of death during COVID-19-associated hospital admission (OR, 2.09; 95% CI, 1.09-4.08; P=0.028).
“Our results could be useful to assist physicians in informed risk–benefit discussions to explain COVID-19 risk and enable an evidenced-based approach to national social isolation policies,” the researchers concluded.