Clinical characteristics and outcome of multiple myeloma patients with concomitant COVID-19 at Comprehensive Cancer Centers in Germany

Engelhardt, Monika; Shoumariyeh, Khalid; Rösner, Amelie; Ihorst, Gabriele; Biavasco, Francesca; Meckel, Katharina; Metzler, Ivana von; Treurich, Sebastian; Hebart, Holger; Grube, Matthias; Kull, Miriam; Bassermann, Florian; Schäfer‐Eckart, Kerstin; Hoferer, Anette; Einsele, Hermann; Rasche, Leo; Wäsch, Ralph

doi:10.3324/haematol.2020.262758

Cited by 42 publications

(40 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At data cutoff, the median follow-up time for all patients included was 10.3 months (range, 1.1-22.9). During the follow-up period, the median cycles of ixazomib therapy received by all patients and those who had ixazomib maintenance were 6 (range, 1-20) cycles and 14 (range, [11][12][13][14][15][16][17][18][19][20], respectively. At data cutoff, 56.5% (48/85) of patients remained on ixazomib treatment, including 90% (9/10) of those receiving single-agent ixazomib as maintenance.…”

Section: Treatment Regimen and Exposurementioning

confidence: 99%

“…Besides, the ixazomib-based all-oral regimen combined with cyclophosphamide and dexamethasone (ICd) has shown promising efficacy in phase 2 studies [14,15]. Furthermore, all-oral regimens, including IRd combination, have been suggested as possible options during the pandemic of COVID-19 in different consensus or opinions [16][17][18][19], owing to the fact that using an oral regimen may help to reduce the risk for virus exposure and infection. However, effectiveness and tolerability of novel agent for MM treatment in routine clinical practice often differ from the results reported in registered clinical trials [8,20,21], and the published data on frontline treatment with ixazomibbased regimes in large phase 3 trials and in the real-world setting are limited.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ixazomib-based frontline therapy in patients with newly diagnosed multiple myeloma in real-life practice showed comparable efficacy and safety profile with those reported in clinical trial: a multi-center study

Xia

et al. 2020

Ann Hematol

View full text Add to dashboard Cite

The induction therapy containing ixazomib, an oral proteasome inhibitor, has shown favorable efficacy and safety in clinical trials, but its experience in real-life remains limited. In routine practice, few patients received ixazomib-based induction therapy due to reasons including (1) patients’ preference on oral regimens, (2) concerns on adverse events (AEs) of other intravenous/subcutaneous regimens, (3) requirements for less center visits, and (4) fears of COVID-19 and other infectious disease exposures. With the aim of assessing the real-life effectiveness and safety of ixazomib-based induction therapy, we performed this multi-center, observational study on 85 newly diagnosed multiple myeloma (NDMM) patients from 14 medical centers. Ixazomib-based regimens included ixazomib-lenalidomide-dexamethasone (IRd) in 44.7% of patients, ixazomib-dexamethasone (Id) in 29.4%, and Id plus another agent (doxorubicin, cyclophosphamide, thalidomide, or daratumumab) in 25.9%. Different ixazomib-based therapies were applied due to (1) financial burdens or limitations on local health insurance coverage, (2) concerns on treatment tolerance, and (3) drug accessibility issue. Ten patients received ixazomib maintenance. The median age was 67 years; 43.5% had ISS stage III disease; 48.2% had an Eastern Cooperative Oncology Group performance score ≥ 2; and 17.6% with high-risk cytogenetic abnormalities. Overall response rate for all 85 patients was 95.3%, including 65.9% very good partial response or better and 29.5% complete responses. The median time to response was 30 days. The response rate was similar across different ixazomib-based regimens. Median progression-free survival was not reached. Severe AEs (≥ grade 3) were reported in 29.4% of patients. No grade 3/4 peripheral neuropathy (PN) occurred. Patients received a median of 6 (range 1–20) cycles of ixazomib treatment; 56.6% remained on treatment at data cutoff; 15.3% discontinued treatment due to intolerable AEs. These results support that the ixazomib-based frontline therapy was highly effective with acceptable toxicity in routine practice and the ixazomib oral regimens could be good alternative options for NDMM patients.

show abstract

Section: Treatment Regimen and Exposurementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ixazomib-based frontline therapy in patients with newly diagnosed multiple myeloma in real-life practice showed comparable efficacy and safety profile with those reported in clinical trial: a multi-center study

Xia

et al. 2020

Ann Hematol

View full text Add to dashboard Cite

show abstract

“…Indeed, the rst US study on 100 MM patients from NYC reported morality rates of almost 20% of patients, which was considerably higher than what had been reported in general population [2]. In contrast, the German multiple myeloma study group consortium reported no casualties among all 21 myeloma patients diagnosed with COVID-19 from March 1st to May 31st 2020 at secondary and tertiary comprehensive cancer centers in Germany [3]. So far, no myeloma-speci c risk factors have been identi ed [2,3].…”

Section: Introductionmentioning

confidence: 90%

“…In contrast, the German multiple myeloma study group consortium reported no casualties among all 21 myeloma patients diagnosed with COVID-19 from March 1st to May 31st 2020 at secondary and tertiary comprehensive cancer centers in Germany [3]. So far, no myeloma-speci c risk factors have been identi ed [2,3]. Despite the lack of reliable data, few new guidelines and recommendations for treatment of MM during COVID-19 pandemic have been published [4].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 in a Multiple Myeloma Patient: Cellular and Humoral Immunity Against SARS-CoV-2 in a Short- and Long-term View

Metzler

Campe

Huenecke

et al. 2021

Preprint

View full text Add to dashboard Cite

Multiple myeloma patients are often treated with immunomodulatory drugs, proteasome inhibitors or monoclonal antibodies until disease progression. Chronic therapy in combination with the underlying disease frequently results in severe humoral and cellular immunodeficiency, which often manifests in recurrent infections. Here we report on the clinical management and immunological data of one multiple myeloma patient diagnosed with COVID-19. Despite severe hypogammaglobulinemia, deteriorated T cell counts and neutropenia, the patient unexpectedly combated COVID-19 by balanced response of innate immunity, strong CD8+ and CD4+ T cell activation and differentiation, development of specific T-cell memory subsets, as well as development of anti-SARS-CoV-2 type IgA and IgG antibodies. Even 6 months after re-introduction of lenalidomide maintenance therapy, specific T cell response and antibody levels remained detectable, indicating persisting immunity against SARS-CoV-2. We conclude that in MM patients who tested positive for SARS-CoV-2 and were receiving active MM treatment, immune response assessment could be a useful tool to help guide decision-making regarding the continuation of anti-tumor therapy and supportive therapy.

show abstract

“…Besides the fact that skeletal pain is one of the major presenting symptoms, MM may be diagnosed after an accident or emergency or severe infection, including COVID-19 infection [14,15]. As a consequence, several guidelines have recommended awareness of 'red flag' features from patients' clinical history and physical examination to identify serious pathologies, such as malignancy [16].…”

Section: Introductionmentioning

confidence: 99%

Interdisciplinary approach to multiple myeloma – time to diagnosis and warning signs

Herget

Kälberer

Ihorst

et al. 2020

Leukemia & Lymphoma

View full text Add to dashboard Cite

Delayed diagnosis is a common challenge in the management of multiple myeloma (MM). This prospective interdisciplinary study evaluated symptoms and time to diagnosis (TTD) in 81/295 screened patients at our tertiary center, who were examined by an orthopedist prior to the MM diagnosis. The most frequent complaint was back pain (81%), mainly localized thoracic and/or lumbar. Pain was independent of movement in 85%, occurred at night in 69%, and at multiple localizations in 30% of patients. Notably, 63% patients with an orthopedic disease noticed substantial symptom change before the MM diagnosis was made. The median TTD was 7 months and did not differ significantly between patients with or without a preexisting skeletal disease. To avoid delayed diagnosis, physicians should consider MM as a differential diagnosis, whenever warning signs such as skeletal pain independent from movement, at night, at various localizations, and change in pain characteristics accompanied by fatigue, are reported.

show abstract

Clinical characteristics and outcome of multiple myeloma patients with concomitant COVID-19 at Comprehensive Cancer Centers in Germany

Cited by 42 publications

References 23 publications

Ixazomib-based frontline therapy in patients with newly diagnosed multiple myeloma in real-life practice showed comparable efficacy and safety profile with those reported in clinical trial: a multi-center study

Ixazomib-based frontline therapy in patients with newly diagnosed multiple myeloma in real-life practice showed comparable efficacy and safety profile with those reported in clinical trial: a multi-center study

COVID-19 in a Multiple Myeloma Patient: Cellular and Humoral Immunity Against SARS-CoV-2 in a Short- and Long-term View

Interdisciplinary approach to multiple myeloma – time to diagnosis and warning signs

Contact Info

Product

Resources

About