Age, high-risk multiple myeloma (MM), renal disease, and active or progressive MM were predictive of worse outcomes for patients with plasma cell disorders and COVID-19, found a retrospective international study in Blood.
The study included 650 patients with plasma cell disorders, most of whom had MM (95.5%). Patients were primarily from Spain (28.62%), France (28.46%), the United States (19.38%), and the United Kingdom (14.77%).
The death rate was 34.1% overall, with the United States on the lower end (24.6%) and United Kingdom on the higher end (55.2%). In the United States, the death rate was 21.57% among hospitalized patients and 94.44% among hospitalized patients on ventilator support.
A multivariate analysis revealed 4 independent predictors of adverse outcome for patients with plasma cell disorders and COVID-19: age (odds ratio [OR], 1.04; 95% 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), and high-risk MM (OR, 2.35; 95% CI, 1.20-4.66). High-risk disease was defined as patients with del(17p), t(4;14), amp1q, or t(14;16) alterations.
Several characteristics were found not to be associated with worse outcomes from COVID-19: time from diagnosis, number of prior lines of treatment, history of prior transplant, and prior exposure to proteasome inhibitors, immunomodulatory agents, or anti-CD38 antibody.
“Based on the observations reported here, 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,” the study authors wrote.
For elderly patients, they explained, disease control is also beneficial, but may be achieved using regimens that decrease frequency of office visits in order to avoid exposure to the virus.
Chari A, Samur MK, Martinez-Lopez J, et al. Clinical features associated with COVID-19 outcome in MM: First results from International Myeloma Society Dataset. Blood. Published online November 6, 2020. doi:10.1182/blood.2020008150