Clinical Scorecard: Clinical Features and Prognostic Indicators of In-Hospital Mortality in Patients with Multiple Myeloma and SARS-CoV-2 Infection
At a Glance
Category
Detail
Condition
Multiple Myeloma patients infected with SARS-CoV-2 (COVID-19)
Key Mechanisms
Impaired humoral and cellular immunity due to MM and its treatments, leading to increased susceptibility to viral infections and complications from COVID-19
Target Population
Hospitalized patients with Multiple Myeloma and confirmed SARS-CoV-2 infection
Care Setting
Hospital inpatient care in multiple Spanish healthcare centers
Key Highlights
MM patients have severely impaired humoral immunity and dysfunctional cellular and innate immunity, increasing vulnerability to infections including COVID-19.
MM treatments (chemotherapy, corticosteroids, proteasome inhibitors, immunomodulatory drugs, CD38 monoclonal antibodies) variably impact immune function and infection risk.
This is the first large multicenter case-series analyzing clinical characteristics, outcomes, and prognostic factors of hospitalized MM patients with COVID-19 compared to a matched noncancer cohort.
Guideline-Based Recommendations
Diagnosis
Confirm SARS-CoV-2 infection by nasopharyngeal swab and real-time reverse transcriptase PCR assay according to national disease control guidelines.
Management
Consider the impact of MM disease status and ongoing treatments on immune function when managing COVID-19 in MM patients.
Apply intensive supportive care and evaluate potential use of antiviral, anti-inflammatory, and anticoagulant therapies as per evolving COVID-19 treatment protocols.
Monitoring & Follow-up
Monitor clinical, laboratory, and treatment variables closely during hospitalization to assess disease progression and response.
Use prognostic factors including age, comorbidities, and MM-specific features to stratify risk of in-hospital mortality.
Risks
Increased risk of severe COVID-19 and mortality associated with older age, male sex, comorbidities, and immunosuppression from MM and its treatments.
Risk of cytopenias and viral reactivations (e.g., varicella-zoster) due to MM therapies.
Patient & Prescribing Data
Hospitalized Multiple Myeloma patients with confirmed COVID-19 infection
MM treatments have differential effects on immune function; some increase infection risk (e.g., corticosteroids, proteasome inhibitors, CD38 antibodies), while immunomodulatory drugs may enhance NK and T-cell function but also carry risks of cytopenia and thrombosis.
Clinical Best Practices
Perform comprehensive clinical and laboratory assessment of MM patients admitted with COVID-19 to identify prognostic indicators.
Adjust management strategies considering MM disease status, treatment history, and comorbidities to optimize outcomes.
Use matched noncancer COVID-19 patient data as a reference to contextualize MM patient outcomes.
Apply rigorous statistical methods to identify independent predictors of mortality and guide clinical decision-making.
by Joaquín Martínez-López, María-Victoria Mateos, Cristina Encinas, Anna Sureda, José Ángel Hernández-Rivas, Ana Lopez de la Guía, Diego Conde, Isabel Krsnik, Elena Prieto, Rosalía Riaza Grau, Mercedes Gironella, María Jesús Blanchard, Nerea Caminos, Carlos Fernández de Larrea, María Alicia Senin, Fernando Escalante, José Enrique de la Puerta, Eugenio Giménez, Pilar Martínez-Barranco, Juan José Mateos, Luis Felipe Casado, Joan Bladé, Juan José Lahuerta, Javier de la Cruz, Jesús San-Miguel
