COVID-19 infections and clinical outcomes in patients with multiple myeloma in New York City: A cohort study from five academic centers Journal Article

Authors: Hultcrantz, M.; Richter, J.; Rosenbaum, C. A.; Patel, D.; Smith, E. L.; Korde, N.; Lu, S. X.; Mailankody, S.; Shah, U. A.; Lesokhin, A. M.; Hassoun, H.; Tan, C.; Maura, F.; Derkach, A.; Diamond, B.; Rossi, A.; Pearse, R. N.; Madduri, D.; Chari, A.; Kaminetzky, D.; Braunstein, M. J.; Gordillo, C.; Reshef, R.; Taur, Y.; Davies, F. E.; Jagannath, S.; Niesvizky, R.; Lentzsch, S.; Morgan, G. J.; Landgren, O.
Article Title: COVID-19 infections and clinical outcomes in patients with multiple myeloma in New York City: A cohort study from five academic centers
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. Significance: Patients with multiple myeloma are immunocompromised, raising the question whether they are at higher risk of severe COVID-19 disease. In this large case series on COVID-19 in patients with multiple myeloma, we report 29% mortality rates among hospitalized patients and identify race/ethnicity as the most significant risk factor for severe outcome.See related commentary by Munshi and Anderson, p. 218. This article is highlighted in the In This Issue feature, p. 215. ©2020 American Association for Cancer Research.
Journal Title: Blood Cancer Discovery
Volume: 1
Issue: 3
ISSN: 2643-3230
Publisher: American Association for Cancer Research  
Date Published: 2020-11-01
Start Page: 234
End Page: 243
Language: English
DOI: 10.1158/2643-3230.Bcd-20-0102
PUBMED: 34651141
PROVIDER: scopus
PMCID: PMC7668224
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding author is MSK author Malin Hultcrantz -- Source: Scopus
Citation Impact
MSK Authors
  1. Hani Hassoun
    266 Hassoun
  2. Ying Taur
    141 Taur
  3. Alexander Meyer Lesokhin
    270 Lesokhin
  4. Sydney X Lu
    98 Lu
  5. Eric Smith
    74 Smith
  6. Carl Ola Landgren
    334 Landgren
  7. Neha Sanat Korde
    154 Korde
  8. Urvi A Shah
    113 Shah
  9. Francesco Maura
    52 Maura
  10. Benjamin Diamond
    31 Diamond
  11. Andriy Derkach
    89 Derkach
  12. Dhwani Patel
    22 Patel
  13. Carlyn Rose Tan
    58 Tan