Survival in multiple myeloma and SARS-COV-2 infection through the COVID-19 pandemic: Results from the epicovideha registry

• Authors: MUSTO Pellegrino; SALMANTON-GARCIA Jon; SGHERZA Nicola; BERGANTIM Rui; FARINA Francesca; GLENTHOJ Andreas; GULDANE Cengiz Seval; WEINBERGEROVÁ Barbora; BONUOMO Valentina; BILGIN Yavuz M; JAAP van Doesum; JAKSIC Ozren; VISEK Benjamin; FALCES-ROMERO Iker; MARCHETTI Monia; DAVILA-VALLS Julio; MARTIN-PEREZ Sonia; NUCCI Marcio; LOPEZ-GARCIA Alberto; ITRI Federico; BUQUICCHIO Caterina; VERGA Luisa; PIUKOVICS Klara; NAVRATIL Milan; COLLINS Graham P; JIMENEZ Moraima; FRACCHIOLLA Nicola S; LABRADOR Jorge; PREZIOSO Lucia; ROSSI Elena; COLOVIC Natasha; MEERS Stef; KULASEKARARAJ Austin; CUCCARO Annarosa; BLENNOW Ola; VALKOVIC Toni; SILI Uluhan; LEDOUX Marie-Pierre; BATINIC Josip; PASSAMONTI Francesco; MACHADO Marina; DUARTE Rafael F; POULSEN Christian Bjorn; MENDEZ Gustavo-Adolfo; ESPIGADO Ildefonso; DEMIRKAN Fatih; CERNAN Martin; CATTANEO Chiara; PETZER Verena; MAGLIANO Gabriele; GARCIA-VIDAL Carolina; EL-ASHWAH Shaimaa; GOMES-DA-SILVA Maria; VENA Antonio; ORMAZABAL-VELEZ Irati; JENS van Praet; DARGENIO Michelina; DE-RAMON Cristina; ILARIA Del Principe Maria; MARQUES-DE-ALMEIDA Joyce; WOLF Dominik; SZOTKOWSKI Tomas; OBR Ales; COLAK Goekce Melis; NORDLANDER Anna; IZUZQUIZA Macarena; CABIRTA Alba; ZAMBROTTA Giovanni Paolo Maria; CORDOBA Raul; ZAK Pavel; AMMATUNA Emanuele; MAYER Jiri; ILHAN Osman; GARCIA-SANZ Ramon; QUATTRONE Martina; ARELLANO Elena; NUNES-RODRIGUES Raquel; EMARAH Ziad; AIELLO Tommaso Francesco; HANAKOVA Michaela; RACIL Zdenek; BAVASTRO Martina; LIMONGELLI Alessandro; RAHIMLI Laman; MARCHESI Francesco; CORNELY Oliver A; PAGANO Livio
• Year of publication: 2024
• Type: Article in Periodical
• Magazine / Source: Hematological Oncology
• MU Faculty or unit: Faculty of Medicine
• Web: https://onlinelibrary.wiley.com/doi/10.1002/hon.3240
• Doi: http://dx.doi.org/10.1002/hon.3240
• Keywords: COVID-19; hematological malignancy; multiple myeloma; SARS-CoV-2
• Description: Patients affected by multiple myeloma (MM) have an increased risk of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection and subsequent coronavirus (20)19 disease (COVID-19)-related death. The changing epidemiological and therapeutic scenarios suggest that there has been an improvement in severity and survival of COVID-19 during the different waves of the pandemic in the general population, but this has not been investigated yet in MM patients. Here we analyzed a large cohort of 1221 patients with MM and confirmed SARS-CoV-2 infection observed between February 2020, and August 2022, in the EPICOVIDEHA registry from 132 centers around the world. Median follow-up was 52 days for the entire cohort and 83 days for survivors. Three-hundred and three patients died (24%) and COVID-19 was the primary reason for death of around 89% of them. Overall survival (OS) was significantly higher in vaccinated patients with both stable and active MM versus unvaccinated, while only a trend favoring vaccinated patients was observed in subjects with responsive MM. Vaccinated patients with at least 2 doses showed a better OS than those with one or no vaccine dose. Overall, according to pandemic waves, mortality rate decreased over time from 34% to 10%. In multivariable analysis, age, renal failure, active disease, hospital, and intensive care unit admission, were independently associated with a higher number of deaths, while a neutrophil count above 0.5 x 109/L was found to be protective. This data suggests that MM patients remain at risk of SARS-CoV-2 infection even in the vaccination era, but their clinical outcome, in terms of OS, has progressively improved throughout the different viral phases of the pandemic.