Higher Rates of COVID-19 Mortality for Patients with Multiple Myeloma

According to new data published in Blood, patients with multiple myeloma (MM) who are hospitalized for COVID-19 infection face higher mortality compared with patients without MM, with age, disease status, and renal involvement serving as predictors of worse outcomes.

MM is a hematological cancer of the plasma cells, particularly within bone marrow. Immunosuppression often presents alongside MM, and infections are a common cause of morbidity and death in this patient population. Due to this, it is important to understand the relationship between MM and COVID-19-related outcomes, especially regarding susceptibility and the effect of therapy on infection.

This retrospective study utilizes data from the International Myeloma Society MM COVID-19 data set. In total, the study included 650 patients with plasma disorders from 10 different countries. All patients had lab-confirmed positive SARS-CoV-2 infections. The median age of participants was 69 years, and 96% had MM. Around 36% were recently diagnosed and 54% were receiving first-line therapy.

At time of analysis, 33% of participants have died, with geographic variability across centers, ranging from 27% to 57% of hospitalized patients.

The researchers identified age, late-stage or high-risk disease, renal disease, progressive disease, and one or more comorbidities as risk factors for higher rates of mortality. Of these factors, age, high-risk disease, renal disease, and progressive disease were independent predictors of adverse outcomes of COVID-19 infection.

History of transplant or other MM treatments were not found to be associated with COVID-19 outcomes. Patients who achieved a complete response to treatment had superior COVID-19 outcomes when compared with those with relapsed disease or who achieved a partial response to treatment.

“Young patients with high-risk and/or active MM need to receive therapies to control their disease, which will also improve their outcome if infected with COVID-19. For elderly patients with a higher death rate from COVID-19, disease control is also beneficial, but may be achieved using regimens that decrease frequency of office visits (eg, oral drug) in order to avoid exposure to the virus,” wrote the authors. “Importantly, continued therapy including steroids and high-dose therapy are not contraindicated, and in fact should be continued to achieve better MM control, which is associated with improved outcome even with COVID-19 infection.”

The authors reported limitations of the study include the small sample size and retrospective nature.