Managing multiple myeloma during COVID-19 pandemic
In the last year, the COVID-19 pandemic created panic and uncertainty for everyone, but most notably individuals with cancer and other immunosuppressing diseases, and their providers.
Anastasios Raptis, MD, PhD, hematology oncologist at UPMC Hillman Cancer Center, spoke with Healio about managing patients with multiple myeloma during the pandemic and what has been learned.
Healio: At a little over the 1-year mark since the COVID-19 pandemic began, what has been learned about the relationship between COVID and multiple myeloma?
Raptis: Patients with myeloma are immunosuppressed and are at high risk for experiencing severe complications and morbidity from COVID-19 infection. Also, patients with myeloma are of advanced age, which by itself is a significant risk factor for adverse outcome.
Healio: What advice do you have for clinicians managing patients with multiple myeloma who have a suspected or confirmed case of COVID-19?
Raptis: It is important to continue myeloma specific treatment since the risk for death is significantly higher with myeloma than with COVID-19. Moreover, inducing myeloma in remission will lead to improvement of immune function.
Healio: Is treatment modification necessary for patients with multiple myeloma who have contracted COVID-19? How has the pandemic impacted maintenance therapy? CAR T-cell therapy?
Raptis: Treatment modification can be considered if it does not affect the anti-myeloma activity of the treatment. It has been reported that patients on maintenance with lenalidomide (Revlimid; Bristol Myers Squibb) who contracted COVID-19 had less severe symptoms than patients off maintenance. The pandemic did affect the CART-cell program, as it was suspended in several centers for months. At this point all CAR T-cell programs are up and running.
Healio: What has the conversation around vaccination looked like with patients in your practice?
Raptis: Most patients with multiple myeloma have some protection against SARS-CoV-2 after the first vaccination, although antibody responses are likely to be attenuated. Protection is increased after a second vaccination, however, is less than general population.
Healio: How has the pandemic affected clinical trial enrollment? Has this had a significant impact on practice?
Raptis: It affected enrollment to clinical trials during the lockdown. Now all trials are open for enrollment.
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Healio Interview
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