Multiple Myeloma Coverage from Every Angle

COVID-19 and Novel Agents for Myeloma: From a Single Center in the Czech Republic

By: Myles Starr
Posted: Wednesday, September 1, 2021

A cohort of 50 outpatients with multiple myeloma tested positive for COVID-19 from a single center in the Czech Republic, and pneumonia in 28 warranted hospitalizations. Novel drug therapies included daratumumab, lenalidomide, and bortezomib. According to the findings of this retrospective study, published in the Annals of Hematology by Zdenek Kral, MD, of University Hospital, Brno, Czech Republic, and colleagues, there appeared to be no significant correlation between these various types of antimyeloma therapies and outcomes from COVID-19 infection.

“Providing anti-COVID vaccinations to all multiple myeloma patients should be strongly recommended,” the investigators concluded. “After recovery from COVID-19 infection, the continuation of antimyeloma therapy is recommended.”

All patients in the study were treated at the University Hospital in Brno; in addition to corticosteroids as part of treatment (dexamethasone or prednisone), 15 patients were given daratumumab-based therapy; 17 patients, bortezomib-based therapy with no daratumumab; 12 patients, lenalidomide-based therapy with no daratumumab; and 6 patients, other therapies (eg, carfilzomib or pomalidomide). During treatment for COVID-19, all these myeloma treatments were suspended, given the high risk of infection and hematologic toxicity. Cardiovascular or pulmonary comorbidities were seen in 96 % of participants. The presence of a comorbidity (0–1 vs. ≥ 2), responsive versus nonresponsive disease, and performance status (0–2 vs. ≥ 3) were parameters that affected the hospitalization rate among patients.

Hospitalized patients were treated with thromboembolic prophylaxis and oxygen therapy. In addition, a combination of remdesivir and convalescent plasma was used to treat 12 patients, and steroids and broad-spectrum antibiotics were given to another 12 patients. Of the hospitalized patients, 19 recovered (median, 35 days), and 9 died of COVID-19 infection (median, 10 days.)

After a median recovery of 32 days, all surviving patients were COVID-19–negative and continued myeloma treatments. At a 3-month follow up, these patients were all free of COVID-19.

Disclosure: The study authors reported no conflicts of interest.

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