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. 2022 Dec;27(1):691-699.
doi: 10.1080/16078454.2022.2082725.

Infections in relapsed myeloma patients treated with isatuximab plus pomalidomide and dexamethasone during the COVID-19 pandemic: Initial results of a UK-wide real-world study

Faouzi Djebbari  1 , Alexandros Rampotas  1   2 , Grant Vallance  1 , Fotios Panitsas  3 , Nanda Basker  4 , Gina Sangha  5 , Beena Salhan  6   7   8   9 , Farheen Karim  9   10 , Al-Kaisi Firas  11   12 , Amy Gudger  9   13   14 , Loretta Ngu  15 , Matt Poynton  16 , Ho Pui Jeff Lam  17 , Lowri Morgan  18 , Laura Yang  19 , Jennifer Young  20 , Mairi Walker  21 , Ismini Tsagkaraki  22 , Laura Anderson  23 , Saleena Rani Chauhan  9   24 , Rebecca Maddams  25 , Richard Soutar  26 , Margarita Triantafillou  27 , Steve Prideaux  28 , Abubaker Obeidalla  12 , Toby A Eyre  1 , Ceri Bygrave  18 , Supratik Basu  9   10   14 , Karthik Ramasamy  1
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Free article

Infections in relapsed myeloma patients treated with isatuximab plus pomalidomide and dexamethasone during the COVID-19 pandemic: Initial results of a UK-wide real-world study

Faouzi Djebbari et al. Hematology. 2022 Dec.
Free article

Abstract

Objectives: There are no real-world data describing infection morbidity in relapsed/refractory myeloma (RRMM) patients treated with anti-CD38 isatuximab in combination with pomalidomide and dexamethasone (IsaPomDex). In this UK-wide retrospective study, we set out to evaluate infections experienced by routine care patients who received this novel therapy across 24 cancer centres during the COVID-19 pandemic.

Methods: The primary endpoint was infection morbidity (incidence, grading, hospitalization) as well as infection-related deaths. Secondary outcomes were clinical predictors of increased incidence of any grade (G2-5) and high grade (≥G3) infections.

Results: In a total cohort of 107 patients who received a median (IQR) of 4 cycles (2-8), 23.4% of patients experienced ≥1 any grade (G2-5) infections (total of 31 episodes) and 18.7% of patients experienced ≥1 high grade (≥G3) infections (total of 22 episodes). Median time (IQR) from start of therapy to first episode was 29 days (16-75). Six patients experienced COVID-19 infection, of whom 5 were not vaccinated and 1 was fully vaccinated. The cumulative duration of infection-related hospitalizations was 159 days. The multivariate (MVA) Poisson Regression analysis demonstrated that a higher co-morbidity burden with Charlson Co-morbidity Index (CCI) score ≥4 (incidence rate ratio (IRR) = 3, p = 0.012) and sub-optimal myeloma response less than a partial response (<PR) (p = 0.048) are independent predictors of ≥ G3 infections.

Conclusion: Our study described initial results of infection burden during IsaPomDex treatment. We recommend close monitoring particularly in elderly patients with co-morbidities, the effective use of an-infective prophylaxis, as well as optimal vaccination strategies, to limit infections.

Keywords: Infections; isatuximab; myeloma; pomalidomide; real-world.

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