Multiple myeloma in times of SARS-CoV-2 in Mexico

ABSTRACT

Multiple Myeloma (MM) is a heterogeneous oncological disease in its molecular component that in turn generates clinical variability, its risk is defined according to the Revised International Staging System, which considers serious high levels of DHL and Beta2 microglobulina, low levels of albumin and the presence of some cytogenetic alteration, [del 17p13, t (14;14), and t (14;16)], the high-risk group is characterized by early relapse and short survival. At this time of the SARS-CoV-2 (COVID-19) pandemic, the management of patients with multiple myeloma has been indirectly affected by the lack of opportunity in diagnosis and management. In addition to there are data that suggest that the state of immunosuppression typical of the disease, combined with immunosuppressive and immunomodulatory therapy, makes them at high risk of complicating themselves and dying when they acquire the disease from COVID-19. However, there are no proper myeloma registries to corroborate this and in the COVID-19/cancer registries complications are reported mainly in lung cancer and those that are within 4 weeks of receiving intense chemotherapy. In Mexico and Latin America a brief survey only found isolated cases, the data has yet to be analyzed. The low frequency of patients with MM and COVID-19 is probably due to the care and isolation that is had with them beforehand. Since MM is a heterogeneous disease, we must continue to evaluate the risk at diagnosis and give full treatment to those at high risk, for this we must adjust the measures to reduce the risk of exposure to COVID-19, reduce visits to care units as much as possible, adjust first-line treatments according to the characteristics of each patient and monitor patients with intensive therapies and those requiring transplantation with tests for COVID-19 of hematopoietic progenitor cells. The COVID-19 pandemic is a catastrophe without a present, not only due to the morbidity and mortality of the infection, it has also generated saturation of health services, increasing complications and deaths from other diseases due to the lack of opportunity in care and Multiple Myeloma is no exception.