SARS-Cov-2 infection increases mortality in multiple myeloma patients

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https://www.nature.com/articles/s41408-020-00372-5

In our study, we identified that Multiple Myeloma patients represent a vulnerable population to COVID-19 disease. We investigated characteristics and outcomes of 167 MM patients hospitalized with COVID-19 in 73 hospitals from the Spanish Myeloma Group (PETHEMA/GEM) between March and April 2020. Interestingly, we have compared the outcome with a matched cohort without cancer.The risk of death in MM patients increased by 50% compared (34% vs 23% mortality) to the matched population. The main prognostic factors for hospital death by COVID-19 in MM patients were advanced age, male sex, active MM disease and renal failure at admission. The presence of immunoparesia and the anti-MM therapy with proteasome inhibitors, immunomodulatory drugs or monoclonal antibodies did not impact in the Covid-19 severity and hospital death.

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We have learnt several lessons for improving our patients management in future similar situations. MM patients should be actively protected from SARS-Cov-2 infection until an effective vaccine is available. This imply to minimize visits to the hospital and maintain the social distance,  but at the same time patients should be aware that an appropriate disease control is most important particularly in the most vulnerable MM populations: males, >65 years with active disease and renal impairment would benefit of oral treatments and staying at home whilst young patients might receive systemic therapy optimizing the circuits at the hospital. MM patients requiring treatment due to active disease should regularly be both checked for Covid-19-related symptomatology and tested for COVID-19 by PCR. Large collaborative studies can provide prompt evidence to guide practice in time of healthcare crisis.

Joaquin Martinez-Lopez

Professor, Hospital 12 de Octubre. Complutense University. CNIO

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