Article ; Online: Management of patients with multiple myeloma and COVID-19 in the post pandemic era: a consensus paper from the European Myeloma Network (EMN).
2023 Volume 37, Issue 6, Page(s) 1175–1185
Abstract: ... Network has provided an expert consensus to guide patient management in this era. Vaccination with variant ... for breakthrough infections and severe COVID-19 outcomes, including hospitalization and death. The European Myeloma ... are usually mild. However, patients with multiple myeloma (MM) present an increased risk ...
| Abstract | In the post-pandemic COVID-19 period, human activities have returned to normal and COVID-19 cases are usually mild. However, patients with multiple myeloma (MM) present an increased risk for breakthrough infections and severe COVID-19 outcomes, including hospitalization and death. The European Myeloma Network has provided an expert consensus to guide patient management in this era. Vaccination with variant-specific booster vaccines, such as the bivalent vaccine for the ancestral Wuhan strain and the Omicron BA.4/5 strains, is essential as novel strains emerge and become dominant in the community. Boosters should be administered every 6-12 months after the last vaccine shot or documented COVID-19 infection (hybrid immunity). Booster shots seem to overcome the negative effect of anti-CD38 monoclonal antibodies on humoral responses; however, anti-BCMA treatment remains an adverse predictive factor for humoral immune response. Evaluation of the immune response after vaccination may identify a particularly vulnerable subset of patients who may need additional boosters, prophylactic therapies and prevention measures. Pre-exposure prophylaxis with tixagevimab/cilgavimab is not effective against the new dominant variants and thus is no longer recommended. Oral antivirals (nirmatrelvir/ritonavir and molnupiravir) and remdesivir are effective against Omicron subvariants BA.2.12.1, BA.4, BA.5, BQ.1.1 and/or XBB.1.5 and should be administered in MM patients at the time of a positive COVID-19 test or within 5 days post symptoms onset. Convalescent plasma seems to have low value in the post-pandemic era. Prevention measures during SARS-CoV-2 outbreaks, including mask wearing and avoiding crowded places, seem prudent to continue for MM patients. |
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| MeSH term(s) | Humans ; COVID-19/epidemiology ; Multiple Myeloma/therapy ; SARS-CoV-2 ; COVID-19 Serotherapy ; Consensus ; Pandemics ; Antibodies, Neutralizing |
| Chemical Substances | Antibodies, Neutralizing |
| Language | English |
| Publishing date | 2023-05-04 |
| Publishing country | England |
| Document type | Journal Article ; Review |
| ZDB-ID | 807030-1 |
| ISSN | 1476-5551 ; 0887-6924 |
| ISSN (online) | 1476-5551 |
| ISSN | 0887-6924 |
| DOI | 10.1038/s41375-023-01920-1 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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