Brazilian Experience With COVID-19 Infections in Patients With Myeloma

By: Celeste L. Dixon
Posted: Thursday, November 9, 2023

Results of a study of 91 patients in Brazil with multiple myeloma who were also diagnosed with COVID-19 between April 2020 and January 2022 revealed that increased mortality from COVID-19 was most closely associated with Eastern Cooperative Oncology Group (ECOG) performance status. However, the severity of COVID-19 infection was most associated with particular multiple myeloma treatment regimens. Marcia Garnica, MD, PhD, of the Universidade Federal do Rio de Janeiro, and colleagues also found that for most patients (63%), having COVID-19 delayed their multiple myeloma treatment. This outcome is notable for its potential impact on long-term prognosis, the team reported in Hematology, Transfusion and Cell Therapy.

The most important strategies to limit severe COVID-19–related events among patients with multiple myeloma, particularly older individuals with comorbidities, are optimal vaccination, close monitoring (in both the short and long term) if COVID-19 is contracted, and access to COVID-19 treatments, the authors determined. The patients studied (64% with comorbidities) had high frequencies of COVID-19–related hospitalization (66%), ventilatory support (44%), intensive care unit (ICU) admission (37%), and deaths (30% overall; 73% among those admitted to the ICU).

“Corticosteroids (P = .02) and monoclonal antibodies (P < .01) increased [the] rates of ventilatory support, and corticosteroids (P = .01) and immunomodulatory drugs (P = .03) were associated with ICU admission,” explained Dr. Garnica and co-investigators. Older age (P = .05) and hypertension (P = .02) were independently associated with hospitalization.

Although vaccination is crucial in this population, they emphasized, seroconversion is lower in patients with multiple myeloma compared with the general population. As such, patients remain at risk of breakthrough COVID-19 infections even after complete vaccination.

Disclosure: The study authors reported no conflicts of interest.

Hematology, Transfusion and Cell Therapy

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