A study published in Blood identified the following factors as predictive of worse outcomes for patients with multiple myeloma (MM) who contract COVID-19: age, high-risk disease, renal disease, and active or progressive MM.
The retrospective study included 650 patients with plasma cell disorders, most of whom (96%) had MM. Patients were identified from the International Myeloma Society, and the study included those from Spain (28.62%), France (28.46%), the United States (19.38%), and the United Kingdom (14.77%). Analyses were performed on hospitalized patients. Median patient age was 69 years, and more than half (54%) were receiving first-line therapy.
One-third of patients (33%) died, with the United States have a lower proportion of deaths (24.6%) compared with the United Kingdom (55.2%). The U.S. death rate was 21.57% among hospitalized patients and 94.44% among hospitalized patients on a ventilator.
Multivariate analysis identified four independent predictors of adverse outcomes in patients with MM and COVID-19:
- Age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01-1.08)
- Renal disease (OR, 2.71; 95% CI, 1.23-6.08)
- Active or progressive MM (OR, 1.91, 95% CI, 0.96-3.81)
- High-risk MM (defined as patients with del(17p), t(4;14), amp1q, or t(14;16) alterations; OR, 2.35; 95% CI, 1.20-4.66).
History of transplant (including within a year of COVID-19 diagnosis) and other anti-MM treatments were not associated with COVID-19 survival.
“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,” the researchers concluded of their findings.