Multiple Myeloma in the Time of COVID-19.
Acta Haematol
; 143(5): 410-416, 2020.
Article
in English
| MEDLINE | ID: covidwho-94334
ABSTRACT
We provide our recommendations (not evidence based) for managing multiple myeloma patients during the pandemic of COVID-19. We do not recommend therapy for smoldering myeloma patients (standard or high risk). Screening for COVID-19 should be done in all patients before therapy. For standard-risk patients, we recommend the following ixazomib, lenalidomide, and dexamethasone (IRd) (preferred), cyclophosphamide lenalidomide and dexamethasone (CRd), daratumumab lenalidomide and dexamethasone (DRd), lenalidomide, bortezomib, and dexamethasone (RVd), or cyclophosphamide, bortezomib, and dexamethasone (CyBorD). For high-risk patients we recommend carfilzomib, lenalidomide, and dexamethasone (KRd) (preferred) or RVd. Decreasing the dose of dexamethasone to 20 mg and giving bortezomib subcutaneously once a week is recommended. We recommend delaying autologous stem cell transplant (ASCT), unless the patient has high-risk disease that is not responding well, or if the patient has plasma cell leukemia (PCL). Testing for COVID-19 should be done before ASCT. If a patient achieves a very good partial response or better, doses and frequency of drug administration can be modified. After 10-12 cycles, lenalidomide maintenance is recommended for standard-risk patients and bortezomib or ixazomib are recommended for high-risk patients. Daratumumab-based regimens are recommended for relapsed patients. Routine ASCT is not recommended for relapse during the epidemic unless the patient has an aggressive relapse or secondary PCL. Patients on current maintenance should continue their therapy.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Antineoplastic Combined Chemotherapy Protocols
/
Pandemics
/
Lymphopenia
/
Multiple Myeloma
/
Antineoplastic Agents
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Acta Haematol
Year:
2020
Document Type:
Article
Affiliation country:
000507690
Similar
MEDLINE
...
LILACS
LIS