Multiple Myeloma and COVID-19: Recommendations From an Expert Panel
Posted: Monday, July 20, 2020
A group of experts in both myeloma and infectious diseases headed by Angelo Maiolino, MD, PhD, of the Universidade Federal do Rio de Janeiro, Brazil, published recommendations regarding the management of patients with multiple myeloma from diagnosis to relapse amid the COVID-19 pandemic. Their special considerations for treating this patient population are published in Hematology, Transfusion and Cell Therapy.
Recommendations by the group of hematologists include elaborate infection control protocols and training of staff. These protocols include designating staff to be present in COVID-19 and COVID-19–free areas, screening of staff and visitors, and testing patients with myeloma for COVID-19 before beginning treatment. The group also suggests that medical and nursing visits, routine lab testing, catheter placement, and other regular visits be scheduled as infrequently as possible.
Regarding treatment of multiple myeloma during the pandemic, patients with aggressive disease producing anemia, renal dysfunction, hypercalcemia, and leukemia should begin treatment as soon as possible. For patients who become actively infected with COVID-19, myeloma treatment should be postponed for at least 2 weeks. Fit patients can be treated with standard therapy, whereas frail patients may benefit from an oral-only regimen to reduce visits to the cancer unit. Patients with stable disease can remain on their treatment regimen, and those with relapsed disease should try to postpone treatment initiation if they do not have aggressive disease. No specific regimens are recommended, and supportive care should continue for all patients; however, bisphosphonates can be deferred for those with no signs of active bone disease and no hypercalcemia.
Disclosure: The authors reported no conflicts of interest.