COVID-19 and Multiple Myeloma: Update From Stockholm
Posted: Monday, October 19, 2020
According to findings, patients with multiple myeloma who are infected with COVID-19 have a high risk for mortality, likely because of immune dysregulation under disease progression or treatment with lenalidomide and dexamethasone based on a cohort of patients from Stockholm from March to May 2020 in the European Journal of Haematology. Immunoparesis does not appear to correlate with an increased risk of adverse effects from COVID-19, noted Hareth Nahi, MD, PhD, of the Karolinska Institute, Stockholm, and colleagues.
“As there is currently no vaccine or specific treatments available, it is necessary to carefully consider clinical management and treatment of patients with multiple myeloma in the context of COVID‐19,” the authors concluded.
In the report, the authors evaluated nine patients infected with COVID-19, eight of whom had multiple myeloma and one who had smoldering multiple myeloma. Six patients with multiple myeloma were on daratumumab-based treatments, with the others treated with lenalidomide and dexamethasone. Upon the onset of symptoms, treatment was discontinued for those with multiple myeloma.
Of the nine patients, four died within 3 weeks of presentation of their initial symptoms. Two of the patients who died had progressive disease while on daratumumab, the other two patients had received lenalidomide and dexamethasone and were in remission at the time of their COVID-19 diagnosis.
The authors found that the patient with smoldering multiple myeloma developed COVID-19–specific immunoglobulin M antibodies within a week of the start of their symptoms; however, no seroconversion to immunoglobulin M antibodies occurred. Only one patient of the remaining patients with multiple myeloma developed an immunoglobulin M antibody response. The patients who survived all resumed daratumumab-based treatment, despite remaining COVID-19–positive.
Disclosure: The authors reported no conflicts of interest.