According to research presented at the 2024 ASCO Annual Meeting, patients with multiple myeloma (MM) are highly immunocompromised, either due to the disease’s nature, characterized by hypogammaglobulinemia and impaired plasma cell function, or because of pharmacologic treatments and stem cell transplants. This heightened state of immunosuppression renders patients with MM particularly susceptible to infections.
For the study, investigators examined the changes in mortality rates due to COVID-19, influenza (FLU), and pneumonia in patients with MM during the COVID-19 pandemic.
Utilizing the CDC’s Wide-ranging Online Data for Epidemiologic Research (WONDER) database, the research team collected mortality data for patients with MM who were diagnosed with COVID-19 (code U07.1), FLU, and pneumonia (codes J09-J18), and MM (code C90.0). The study team stratified data by sex and ethnicity to calculate age-adjusted mortality rates (AAMRs) per 100,000 people, facilitating the analysis of mortality trends from 1999 to 2022.
Between 1999 and 2022, 25,271 patients with MM died from COVID-19, FLU, or pneumonia. From 1999 to 2019, the mortality rate was stable, with an AAMR fluctuating between 0.4 to 0.3 per 100,000 and an annual percentage change (APC) of -0.5%. However, from 2019 onwards, there was a significant increase in mortality, with the AAMR rising to 0.5 per 100,000 by 2022, representing an APC of 7%.
Gender-specific analysis revealed that male patients experienced a higher increase in mortality, from an AAMR of 0.4 to 0.7 per 100,000 between 2019 and 2020. Comparatively, the mortality rate among female patients showed a minimal increase, from 0.3 to 0.4 per 100,000. Ethnicity-specific data indicated that Hispanic, White, and African American patients saw increased mortality rates from 2020 to 2022. Asian patients maintained a steady AAMR of 0.2 during the same period.
The study highlights a marked increase in mortality among those with MM with COVID-19, FLU, or pneumonia during 2020-2021, likely driven by the COVID-19 pandemic declared by the World Health Organization in March 2020. Despite the FDA approving the first COVID-19 vaccine in December 2020, new variants and limited vaccine distribution may have sustained higher mortality rates in 2021. A subsequent drop in mortality in 2022 may be attributed to broader vaccine availability and diminished virus virulence. Enhanced awareness and vaccination efforts, including FLU vaccination for immunocompromised patients, could explain the reduced mortality rates observed.
