Department of Hematology/ OncologyMember, Plasma Cell Disorders Program Levine Cancer Institute, Atrium Health/Wake Forest Baptist, Charlotte, NC.
Hematologic Malignancies and Cellular Therapeutics University of Kansas Medical Center, Kansas City, KS.
Clin Lymphoma Myeloma Leuk. 2023 Apr;23(4):273-278. doi: 10.1016/j.clml.2023.01.006. Epub 2023 Jan 18.
COVID-19 has profound effects on patients with multiple myeloma (MM) mainly due to underlying immune dysfunction and associated therapies leading to increased susceptibility to infections. The overall risk of morbidity and mortality (M&M) in MM patients due to COVID-19 infection is unclear with various studies suggesting case fatality rate of 22% to 29%. Additionally, most of these studies did not stratify patients by their molecular risk profile.
Here, we aim to investigate the effects of COVID-19 infection with associated risk factors in MM patients and the effectiveness of newly implemented screening and treatment protocols on outcomes. After obtaining institutional review board approvals from each participating institution, we collected data from MM patients diagnosed with SARS-CoV-2 infection from March 1, 2020, to October 30, 2020, at 2 myeloma centers (Levine Cancer Institute & University of Kansas medical center).
We identified a total of 162 MM patients who had COVID-19 infection. The majority of patients were males (57%) with a median age of 64 years. Most patients had an associated comorbid condition. Their myeloma disease status and prior autologous stem cell transplant at the time of infection had no impact on hospitalization or mortality. In univariate analysis, chronic kidney disease, hepatic dysfunction, diabetes, and hypertension were associated with an increased risk of hospitalization. In multivariate analysis regarding survival, increased age and lymphopenia were associated with increased COVID-19-related mortality.
Our study supports the use of infection mitigation measures in all MM patients, and adjustment of treatment pathways in MM patients diagnosed with COVID-19.
COVID-19 对多发性骨髓瘤(MM)患者有深远的影响,主要是由于潜在的免疫功能障碍和相关治疗导致感染易感性增加。由于 COVID-19 感染,MM 患者的发病率和死亡率(M&M)的总体风险尚不清楚,各种研究表明病死率为 22%至 29%。此外,这些研究大多没有根据患者的分子风险特征对其进行分层。
在这里,我们旨在研究 COVID-19 感染对 MM 患者的影响以及新实施的筛查和治疗方案对结果的影响。在从每个参与机构获得机构审查委员会的批准后,我们从 2020 年 3 月 1 日至 2020 年 10 月 30 日在 2 个骨髓瘤中心(莱文癌症研究所和堪萨斯大学医学中心)收集了被诊断患有 SARS-CoV-2 感染的 MM 患者的数据。
我们共发现 162 名 MM 患者患有 COVID-19 感染。大多数患者为男性(57%),中位年龄为 64 岁。大多数患者有合并症。他们的骨髓瘤疾病状态和感染时的自体干细胞移植都没有影响住院或死亡率。在单变量分析中,慢性肾脏病、肝功能障碍、糖尿病和高血压与住院风险增加相关。在关于生存的多变量分析中,年龄增加和淋巴细胞减少与 COVID-19 相关死亡率增加相关。
我们的研究支持在所有 MM 患者中使用感染缓解措施,并调整诊断为 COVID-19 的 MM 患者的治疗途径。