Clinical features associated with COVID-19 outcome in multiple myeloma: first results from the International Myeloma Society data set.

Chari, Ajai; Samur, Mehmet Kemal; Martinez-Lopez, Joaquin; Cook, Gordon; Biran, Noa; Yong, Kwee; Hungria, Vania; Engelhardt, Monika; Gay, Francesca; García Feria, Ana; Oliva, Stefania; Oostvogels, Rimke; Gozzetti, Alessandro; Rosenbaum, Cara; Kumar, Shaji; Stadtmauer, Edward A; Einsele, Hermann; Beksac, Meral; Weisel, Katja; Anderson, Kenneth C; Mateos, María-Victoria; Moreau, Philippe; San-Miguel, Jesus; Munshi, Nikhil C; Avet-Loiseau, Hervé; Stadtmauer, Edward A.; Anderson, Kenneth C.; Munshi, Nikhil C.

The primary cause of morbidity and mortality in patients with multiple myeloma (MM) is an infection. Therefore, there is great concern about susceptibility to the outcome of COVID-19-infected patients with MM. This retrospective study describes the baseline characteristics and outcome data of COVID-19 infection in 650 patients with plasma cell disorders, collected by the International Myeloma Society to understand the initial challenges faced by myeloma patients during the COVID-19 pandemic. Analyses were performed for hospitalized MM patients. Among hospitalized patients, the median age was 69 years, and nearly all patients (96%) had MM. Approximately 36% were recently diagnosed (2019-2020), and 54% of patients were receiving first-line therapy. Thirty-three percent of patients have died, with significant geographic variability, ranging from 27% to 57% of hospitalized patients. Univariate analysis identified age, International Staging System stage 3 (ISS3), high-risk disease, renal disease, suboptimal myeloma control (active or progressive disease), and 1 or more comorbidities as risk factors for higher rates of death. Neither history of transplant, including within a year of COVID-19 diagnosis, nor other anti-MM treatments were associated with outcomes. Multivariate analysis found that only age, high-risk MM, renal disease, and suboptimal MM control remained independent predictors of adverse outcome with COVID-19 infection. 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. This study provides initial data to develop recommendations for the management of MM patients with COVID-19 infection.