COVID-19 Infections and Clinical Outcomes in Patients with Multiple Myeloma in New York City: A Cohort Study from Five Academic Centers

Malin Hultcrantz, Joshua Richter, Cara A. Rosenbaum, Dhwani Patel, Eric L. Smith, Neha Korde, Sydney X. Lu, Sham Mailankody, Urvi A. Shah, Alexander M. Lesokhin, Hani Hassoun, Carlyn Tan, Francesco Maura, Andriy Derkach, Benjamin Diamond, Adriana Rossi, Roger N. Pearse, Deepu Madduri, Ajai Chari, David KaminetzkyMarc J. Braunstein, Christian Gordillo, Ran Reshef, Ying Taur, Faith E. Davies, Sundar Jagannath, Ruben Niesvizky, Suzanne Lentzsch, Gareth J. Morgan, Ola Landgren

Research output: Contribution to journalArticlepeer-review

40 Scopus citations

Abstract

Patients with multiple myeloma have a compromised immune system, due to both the disease and antimyeloma therapies, and may therefore be particularly susceptible to COVID-19. Here, we report outcomes and risk factors for serious disease in patients with multiple myeloma treated at five large academic centers in New York City in the spring of 2020, during which it was a global epicenter of the SARS-CoV-2 pandemic. Of 100 patients with multiple myeloma (male 58%; median age 68) diagnosed with COVID-19, 75 were admitted; of these, 13 patients (17%) were placed on invasive mechanical ventilation, and 22 patients (29%) expired. Of the 25 nonadmitted patients, 4 were asymptomatic. There was a higher risk of adverse outcome (intensive care unit admission, mechanical ventilation, or death) in Hispanics/Latinos (n = 21), OR = 4.7 (95% confidence interval, 1.3–16.7), and African American Blacks (n = 33), OR = 3.5 (1.1–11.5), as compared with White patients (n = 36). Patients who met the adverse combined endpoint had overall higher levels of inflammatory markers and cytokine activation. None of the other studied risk factors were significantly associated (P > 0.05) with adverse outcome: hypertension (n = 56), OR = 2.2 (0.9–5.4); diabetes (n = 18), OR = 0.9 (0.3–2.9); age >65 years (n = 63), OR = 1.8 (0.7–4.6); high-dose melphalan with autologous stem cell transplant <12 months (n = 7), OR = 0.9 (0.2–5.4); and immunoglobulin G <650 mg/dL (n = 42), OR = 0.9 (0.3–2.2). In this largest cohort to date of patients with multiple myeloma and COVID-19, we found the case fatality rate to be 29% among hospitalized patients and that race/ethnicity was the most significant risk factor for adverse outcome.

Original languageEnglish
Pages (from-to)234-243
Number of pages10
JournalBlood cancer discovery
Volume1
Issue number3
DOIs
StatePublished - 1 Nov 2020

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