Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
[Preprint]. 2020 Jun 11:2020.06.09.20126516.
doi: 10.1101/2020.06.09.20126516.

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

Malin Hultcrantz  1 , Joshua Richter  2 , Cara Rosenbaum  3 , Dhwani Patel  1 , Eric Smith  1 , Neha Korde  1 , Sydney Lu  1 , Sham Mailankody  1 , Urvi Shah  1 , Alexander Lesokhin  1 , Hani Hassoun  1 , Carlyn Tan  1 , Francesco Maura  1 , Andriy Derkacs  4 , Benjamin Diamond  1 , Adriana Rossi  3 , Roger N Pearse  3 , Deepu Madduri  2 , Ajai Chari  2 , David Kaminetsky  5 , Marc Braunstein  5 , Christian Gordillo  6 , Faith Davies  5 , Sundar Jagannath  2 , Ruben Niesvizky  3 , Suzanne Lentzsch  6 , Gareth Morgan  5 , Ola Landgren  1
Affiliations

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

Malin Hultcrantz et al. medRxiv. .

Update in

Abstract

Importance: New York City is a global epicenter for the SARS-CoV-2 outbreak with a significant number of individuals infected by the virus. Patients with multiple myeloma have a compromised immune system, due to both the disease and anti-myeloma therapies, and may therefore be particularly susceptible to coronavirus disease 2019 (COVID-19); however, there is limited information to guide clinical management.

Objective: To assess risk factors and outcomes of COVID-19 in patients with multiple myeloma.

Design: Case-series.

Setting: Five large academic centers in New York City.

Participants: Patients with multiple myeloma and related plasma cell disorders who were diagnosed with COVID-19 between March 10th, 2020 and April 30th, 2020.

Exposures: Clinical features and risk factors were analyzed in relation to severity of COVID-19.

Main outcomes and measures: Descriptive statistics as well as logistic regression were used to estimate disease severity reflected in hospital admissions, intensive care unit (ICU) admission, need for mechanical ventilation, or death.

Results: Of 100 multiple myeloma patients (male 58%; median age 68, range 41-91) diagnosed with COVID-19, 74 (74%) were admitted; of these 13 (18%) patients were placed on mechanical ventilation, and 18 patients (24%) expired. None of the studied risk factors were significantly associated (P>0.05) with adverse outcomes (ICU-admission, mechanical ventilation, or death): hypertension (N=56) odds ratio (OR) 2.3 (95% confidence interval [CI] 0.9-5.9); diabetes (N=18) OR 1.1 (95% CI 0.3-3.2); age >65 years (N=63) OR 2.0 (95% CI 0.8-5.3); high dose melphalan with autologous stem cell transplant <12 months (N=7) OR 1.2 (95% CI 0.2-7.4), IgG<650 mg/dL (N=42) OR=1.2 (95% CI 0.4-3.1). In the entire series of 127 patients with plasma cell disorders, hypertension was significantly associated with the combined end-point (OR 3.4, 95% CI 1.5-8.1).

Conclusions and relevance: Although multiple myeloma patients have a compromised immune system due to both the disease and therapy; in this largest disease specific cohort to date of patients with multiple myeloma and COVID-19, compared to the general population, we found risk factors for adverse outcome to be shared and mortality rates to be within the higher range of officially reported mortality rates.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest Hultcrantz has received funding from the Multiple Myeloma Research Foundation, the Swedish Research Council, Karolinska Institute Foundations, and the Swedish Blood Cancer Foundation. Landgren has received research funding from: National Institutes of Health (NIH), U.S. Food and Drug Administration (FDA), Multiple Myeloma Research Foundation (MMRF), International Myeloma Foundation (IMF), Leukemia and Lymphoma Society (LLS), Perelman Family Foundation, Rising Tides Foundation, Amgen, Celgene, Janssen, Takeda, Glenmark, Seattle Genetics, Karyopharm; Honoraria/ad boards: Adaptive, Amgen, Binding Site, BMS, Celgene, Cellectis, Glenmark, Janssen, Juno, Pfizer; and serves on Independent Data Monitoring Committees (IDMCs) for clinical trials lead by Takeda, Merck, Janssen, and Theradex. The remaining authors declare no relevant conflicts of interest.

References

    1. Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708–1720. - PMC - PubMed
    1. Center for Systems Science and Engineering (CSSE) at Johns Hopkins University B, MD, US. COVID-19 Dashboard. https://coronavirus.jhu.edu/map.html. Published 2020. Accessed 6/7/2020.
    1. Richardson S, Hirsch JS, Narasimhan M, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020. - PMC - PubMed
    1. Oxley TJ, Mocco J, Majidi S, et al. Large-Vessel Stroke as a Presenting Feature of Covid-19 in the Young. N Engl J Med. 2020. - PMC - PubMed
    1. Liang W, Guan W, Chen R, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21(3):335–337. - PMC - PubMed

Publication types