Retrospective review of outcomes of patients with multiple myeloma with COVID-19 infection (two-center study).

Authors

null

Hamid Ehsan

Levine Cancer Institute, Atrium Health, Charlotte, NC

Hamid Ehsan , Alec Britt , Peter M. Voorhees , Barry Paul , Manisha Bhutani , Cindy Varga , Zane Chiad , Brittany K. Ragon , Zainab Shahid , Moussa Shahoud , Al-Ola A. Abdallah , Nausheen Ahmed , Shebli Atrash

Organizations

Levine Cancer Institute, Atrium Health, Charlotte, NC, University of Kansas, Kansas City, KS, Levine Cancer Institute, Charlotte, NC, Department of Hematologic Oncology & Blood Disorders, Levine Cancer Institute/Carolinas Healthcare System, Charlotte, NC, Levine Cancer Institute-University, Charlotte, NC, LCI-Morehead, Charlotte, NC, University of Kansas Cancer Center, Fairway, KS, Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS

Research Funding

No funding received

Background: Coronavirus-2 has profound effects on patients (pts) with Multiple myeloma (MM). At the beginning of the pandemic, COVID-19 infection resulted an overall mortality around 54% (cook et al. BMJ 2020). Here, we report an updated morbidity and fatality for MM. Methods: After obtaining IRB approvals from each participating institute, retrospectively, between January 1, 2021 and August 30, 2021, we identified pts with MM and COVID-19 in two myeloma centers (Levine Cancer Institute (LCI) & the University of Kansas medical center (KUMC). Results: We identified 162 MM pts who had COVID-19 (LCI n=132, UKMC n=30), including 57% males, with median age of 64 years. Current or former smoking reported in 40% of pts. Most pts have associated comorbid conditions: hypertension (45%), hypogammaglobulinemia (32%), CKD (30%), DM (22%), obesity (16.6%), CHF (14%), and CAD (13.5%). Within 3 months prior to infection, treatment included immunomodulatory combinations in 35%, proteasome inhibitors in 28 %, and Daratumumab in 26.5%. Symptoms are summarized in table. 69% had Mild symptoms (no need for hospitalization), 20 % had moderate symptoms (requiring hospitalization), and 9.8% had severe symptoms (ICU level of care). The 18% of pts required oxygen: 6 pts required invasive oxygenation and 3 pts needed vasopressors. The 32% of pts had RRMM, 29.5% on maintenance, and 12% was getting induction. Regarding MM response: >VGPR in 45% and PD in 18%. The 78 pts had ASCT prior to COVID-19 infection: only 3 pts < 1 year and 3 pts < 6 months. MM response or ASCT did not affect hospitalization or mortality.The case fatality rate (CFR) was 6%. In the univariate analysis, CKD, DM, HTN and hepatic dysfunction were associated with an increased risk of hospitalization. However, in multivariate analysis, only CKD, hepatic dysfunction, and Hypogammaglobulinemia significantly increased the risk of admission with only age and lymphopenia were associated with increased COVID-19 related fatatlity. Conclusions: With implementation of center-specific disease control measures and universal screening, pts might have lower case severity and fatality rate than was initially reported.

Symptoms
Number
Frequency
Fatigue
90
56%
Cough
86
53%
Fever
65
40%
Shortness of breath
61
38%
Myalgias
48
30%
Headache
40
25%
Rhinorrhea
29
18%
Diarrhea
25
15%
Nausea
20
12%
Anosmia
14
9%
Abdominal pain
12
7%
Confusion
11
7%
Diaphoresis
11
7%
Weight loss
5
3%
Asymptomatic
46
28%

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Hematologic Malignancies—Plasma Cell Dyscrasia

Track

Hematologic Malignancies

Sub Track

Multiple Myeloma

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 8048)

DOI

10.1200/JCO.2022.40.16_suppl.8048

Abstract #

8048

Poster Bd #

472

Abstract Disclosures