Abstract PO-081: Outcomes of patients with multiple myeloma with COVID-19 infection
Authors: Lunski Michael John , Tawagi Karine , Maslov Diana , Finn Laura 
Published: December 2020

Introduction: While many data have been emerging regarding the outcomes of cancer patients infected with SARS-CoV-2 and their increased risk of mortality, emphasis on patients with hematologic malignancies and how they have been affected during this pandemic is lacking. Louisiana, particularly New Orleans, one of the pandemic epicenters, has a higher-than-average cancer diagnosis rate of multiple myeloma as well as cancer-related deaths. Ochsner Cancer Institute was fortunately prepared for the crisis, which allowed our center to continue taking care of both inpatients and outpatients as needed during the pandemic. Hence, we accumulated ample data among cancer patients and the effects of COVID-19. Here we provide novel initial mortality data on multiple myeloma patients infected with SARS-CoV-2.

Methods: Our retrospective, electronic medical record review included 15 patients with a history of multiple myeloma who tested positive for SARS-CoV-2 PCR from March 1st to April 30th, 2020. Medical records were reviewed for inpatient/outpatient status of infection, outcome of infection, multiple myeloma disease and treatment history, and history of autologous stem cell transplant.

Results: Out of the 15 patients infected, there were 6 deaths (40%). A total of 11 patients were on active treatment, including all 6 patients who died (54.5%), though active treatment did not appear to be a significant risk factor when compared to off-therapy patients (p=.103). Patients older than 65 years seem to be at increased risk of death when compared to patients less than 65 years of age (p=.011). Hospitalized patients were more likely to succumb to infection compared to non-hospitalized patients (p=.044). Of the 15 patients, 4 had a history of autologous stem cell transplant and this was not found to affect mortality (p=.103). Chronic kidney disease was present in 7 patients and did not appear to impact mortality (p=.315). Of these (n=9), 7 patients had hypogammaglobulinemia and 5 of these patients died (71.4%). Overall, 5 of the 6 patients who died were found to have hypogammaglobulinemia (the 6th death did not have immunoglobulins eligible for review). However, the presence of hypogammaglobulinemia did not appear to increase mortality overall (p=.167).

Conclusion: Patients older than 65 years of age with a history of multiple myeloma seem to be at risk of death from COVID-19. Interestingly, a history of autologous stem cell transplant did not appear to affect mortality. While the presence of hypogammaglobulinemia did not affect mortality, its overwhelming finding in the patients who died warrants further discussion in the future. Larger studies are needed to expand on these findings and uncover further characteristics to help stratify at-risk patients in the future.

Citation Format: Michael John Lunski, Karine Tawagi, Diana Maslov, Laura Finn. Outcomes of patients with multiple myeloma with COVID-19 infection [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-081.