Individuals living with multiple myeloma often face concerns about their health, particularly regarding infections like COVID-19. Many individuals with multiple myeloma have successfully recovered from COVID-19. Despite unique challenges, medical advancements and careful management have improved outcomes.
Understanding Vulnerability to COVID-19
Multiple myeloma is a blood cancer affecting plasma cells. The disease weakens the immune system by producing abnormal plasma cells that cannot create enough healthy antibodies, leading to hypogammaglobulinemia. This impairs the body’s ability to fight infections like SARS-CoV-2.
Beyond the disease, various anti-myeloma treatments can further suppress the immune system. Treatments like chemotherapy, corticosteroids, proteasome inhibitors, and immunomodulatory drugs can reduce infection-fighting white blood cells. Even after an autologous stem cell transplant, a patient’s immune system may take time to regain full strength, leaving them susceptible to infections.
Factors Influencing Outcomes
Vaccination status significantly influences COVID-19 outcomes for individuals with multiple myeloma. While vaccine effectiveness against infection may be reduced in this patient group, vaccination still provides substantial protection against severe disease, hospitalization, and death. Booster doses are particularly important for immunocompromised patients to enhance their immune response.
The stage and activity of multiple myeloma also impact COVID-19 severity. Patients with active, progressive, or high-risk myeloma, or those with suboptimal disease control, generally experience worse outcomes. Conversely, individuals who have achieved a complete response to treatment tend to have more favorable outcomes.
Age is another significant predictor of COVID-19 severity, with older individuals, especially those over 65 or 70 years, facing an increased risk of hospitalization and mortality. The presence of other underlying health conditions, known as comorbidities, further influences outcomes. Conditions like chronic kidney disease, diabetes, and hypertension have been associated with a higher likelihood of severe COVID-19 and adverse results.
Access to timely and appropriate COVID-19 treatments also affects survival. Antiviral medications such as nirmatrelvir/ritonavir (Paxlovid), molnupiravir, and remdesivir are effective against various Omicron subvariants. These treatments should be administered within five days of symptom onset or a positive COVID-19 test. Some previously used monoclonal antibody therapies are no longer recommended due to lack of effectiveness against newer variants.
Protective Measures and Management
Staying up-to-date with COVID-19 vaccinations, including variant-specific booster doses, is a primary protective measure for individuals with multiple myeloma. These boosters are generally recommended every 6 to 12 months. Even with vaccination, additional precautions should be practiced to minimize risk.
Consistent adherence to prescribed multiple myeloma treatments is generally advised, unless a healthcare provider recommends otherwise. Delaying treatment is typically only considered during an active COVID-19 infection. Strict personal hygiene, including frequent handwashing, and consistent mask-wearing in public settings are also important.
Avoiding crowded indoor spaces and maintaining physical distancing can further reduce exposure. Prompt communication with the healthcare team at the first sign of COVID-19 symptoms is important for timely evaluation and management. Developing a personalized care plan with an oncologist helps tailor individual risks and treatment strategies. Telemedicine appointments can also help reduce in-person clinic visits, limiting potential exposure. Elective major new treatments, such as autologous stem cell transplants, might be postponed unless the patient has a high-risk disease not responding to current therapies.