ABSTRACT
Aims & Objectives: There is limited data on the incidence and outcomes of COVID-19 infection in Multiple Myeloma (MM) patients. This study aimed to analyze the incidence, outcomes and risk factors for COVID-19 infection and mortality in patients with MM. Patients/Materials & Methods: The study included all the MM patients receiving treatment at our center during a period of five months (15/5/2020 -15/10/2020;N = 52). All patients visiting our center undergo a COVID-19 RT-PCR at each visit, at least 14 days apart or earlier on clinical suspicion of infection. Patients who tested positive for COVID-19 infection were treated in an isolation facility. The primary end points were recovery from the infection and death due to the infection. Results: We enrolled 52 MM patients, of which 9 were newly diagnosed multiple myeloma (NDMM), 10 were relapsed refractory multiple myeloma (RRMM) and 33 patients were in remission. 13 patients were seen weekly (bortezomib + lenalidomide + dexamethasone;cyclophosphamide + bortezomib + dexamethasone;carfilzomib + pomalidomide + dexamethasone), 6 patients every two weekly (bortezomib) and 2 patients monthly (daratumumab or bendamustine). The remaining 29 patients were on oral therapy (lenalidomide, Lenalidomide + dexamethasone and Melphalan) with monthly OPD visits or tele-medicine consultation. 5 patients (9.6%) contracted COVID-19 infection during the study period. 4 patients died (mortality rate 80%) of which 3 patients had NDMM, and one patient had RRMM. The only patient who recovered from the infection was in remission. Among the patients who died, the mean time from the onset of symptoms to death was two days. Discussion & Conclusion: Patients with MM are at a high risk of death if infected with the SARS-CoV-2 virus. Patients with active disease are particularly prone to adverse outcomes with rapid progression of the infection and a very narrow window of opportunity for therapeutic interventions. Such patients may be switched to oral therapy whenever possible. Prevention, early detection and aggressive management of COVID-19 infection is very important in patients with MM.