Document Type : Original Article(s)
Authors
- Zahra Rezaeian 1
- Fatemeh Abedini 1
- Saeedeh Arabzadeh 1
- Maryam Farzan 2
- Mehran Sharifi 1, 3
- Amirreza Manteghinejad 1
1 Cancer Prevention Research Center, Omid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
2 Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Division of Hematology and Oncology, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Patients with multiple myeloma (MM) have compromised immune systems due to the nature of the malignancy and anticancer treatments. This study aims to report the effects of Bortezomib-containing chemotherapy regimens on the severity and mortality of MM patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2).
Method: This retrospective cohort study enrolled MM patients presenting with coronavirus disease 2019 (COVID-19) infection referred to Omid Hospital. Patients were divided into two groups based on whether they received any chemotherapy regimens containing Bortezomib within the last 90 days of admission or not. Clinical and laboratory characteristics, severity, and outcomes of both groups were reported and compared.
Results: Among 48 patients with MM diagnosed with COVID-19 (63% male; median age 66), 33 received chemotherapy. The most common symptoms were fever, cough, and dyspnea, and there was no significant difference between the groups. Only D-dimer had a significant difference in laboratory tests (P = 0.03) and was higher in the chemotherapy group. There was no significant relationship between chemotherapy and severity (risk ratio (RR) = 1.17; 95% confidence interval (CI): 0.37 to 3.71; P = 0.79) or chemotherapy and mortality (RR= 1.00; 95% CI: 0.39 to 2.61; P = 0.99), even after adjusting for baseline C-reactive protein and white blood cell counts.
Conclusion: Our study showed that receiving Bortezomib-containing chemotherapy regimens did not worsen the symptoms and prognosis of MM patients infected with COVID-19. However, further studies with larger sample sizes and longer follow-up times are needed to provide better evidence on this subject.
Highlights
Mehran Sharifi (Google Scholar)
Keywords
How to cite this article:
Rezaeian Z, Abedini F, Arabzadeh S, Farzan M, Sharifi M, Manteghinejad A. The effect of Bortezomib regimen on multiple myeloma patients infected with COVID-19. Middle East J Cancer. 2023; 14(4):537-42. doi: 10.30476/mejc.2022.95615.1784.
- Al-Quteimat OM, Amer AM. The impact of the COVID-19 pandemic on cancer patients. Am J Clin Oncol. 2020;43(6):452-5. doi: 10.1097/COC.0000000000000712.
- Zhang H, Han H, He T, Labbe KE, Hernandez AV, Chen H, et al. Clinical characteristics and outcomes of COVID-19-infected cancer patients: A systematic review and meta-analysis. J Natl Cancer Inst. 2021;113(4):371-80. doi: 10.1093/jnci/djaa168. Erratum in: J Natl Cancer Inst. 2022;114(2):328-30.
- Zarifkar P, Kamath A, Robinson C, Morgulchik N, Shah SFH, Cheng TKM, et al. Clinical characteristics and outcomes in patients with COVID-19 and cancer: a systematic review and meta-analysis. Clin Oncol (R Coll Radiol). 2021;33(3):e180-e191. doi: 10.1016/j.clon.2020.11.006.
- Başcı S, Ata N, Altuntaş F, Yiğenoğlu TN, Dal MS, Korkmaz S, et al. Patients with hematologic cancers are more vulnerable to COVID-19 compared to patients with solid cancers. Intern Emerg Med. 2022;17(1):135-9. doi: 10.1007/s11739-021-02784-y.
- Manteghinejad A, Arabzadeh S, Rezaian Z, Sharifi M, Javanmard SH. COVID-19 breakthrough infections among patients with cancer receiving sinopharm BBIBP-Corv vaccine. Int J Cancer Manag. 2022;15(10): e123887.doi:10.58129/ijcm-123887.
- Song Q, Bates B, Shao YR, Hsu FC, Liu F, Madhira V, et al. Risk and outcome of breakthrough COVID-19 infections in vaccinated patients with cancer: Real-world evidence from the national COVID cohort collaborative. J Clin Oncol. 2022;40(13):1414-27. doi: 10.1200/jco.21.02419.
- Yekedüz E, Utkan G, Ürün Y. A systematic review and meta-analysis: the effect of active cancer treatment on severity of COVID-19. Eur J Cancer. 2020;141:92-104.
- Liu H, Yang D, Chen X, Sun Z, Zou Y, Chen C, et al. The effect of anticancer treatment on cancer patients with COVID‐19: A systematic review and meta‐analysis. Cancer Med. 2021;10(3):1043-56.
- Lin Z, Chen J, Han S. Impact of anti-cancer therapy on disease severity and mortality in cancer patients with COVID-19: a systematic review and meta-analysis. Expert Rev Anticancer Ther. 2021;21(9):1055-66.
- Gerecke C, Fuhrmann S, Strifler S, Schmidt-Hieber M, Einsele H, Knop S. The diagnosis and treatment of multiple myeloma. Dtsch Arztebl Int. 2016;113(27-28):470-6. doi: 10.3238/arztebl.2016.0470.
- Blimark C, Holmberg E, Mellqvist UH, Landgren O, Björkholm M, Hultcrantz M, et al. Multiple myeloma and infections: a population-based study on 9253 multiple myeloma patients. Haematologica. 2015;100(1):107-13. doi: 10.3324/haematol.2014.107714.
- Branagan A, Lei M, Lou U, Raje N. Current treatment strategies for multiple myeloma. JCO Oncol Pract. 2020;16(1):5-14.
- Basler M, Lauer C, Beck U, Groettrup M. The proteasome inhibitor bortezomib enhances the susceptibility to viral infection. J Immunol. 2009;183(10):6145-50. doi: 10.4049/jimmunol.0901596.
- Jee J, Foote MB, Lumish M, Stonestrom AJ, Wills B, Narendra V, et al. Chemotherapy and COVID-19 outcomes in patients with cancer. J Clin Oncol. 2020;38(30):3538-46.
- Arayici ME, Kipcak N, Kayacik U, Kelbat C, Keskin D, Kilicarslan ME, et al. Effects of SARS-CoV-2 infections in patients with cancer on mortality, ICU admission and incidence: a systematic review with meta-analysis involving 709,908 participants and 31,732 cancer patients. J Cancer Res Clin Oncol. 2022:1-14. doi: 10.1007/s00432-022-04191-y.
- Sorouri M, Kasaeian A, Mojtabavi H, Radmard AR, Kolahdoozan S, Anushiravani A, et al. Clinical characteristics, outcomes, and risk factors for mortality in hospitalized patients with COVID-19 and cancer history: a propensity score-matched study. Infect Agent Cancer. 2020;15(1):74. doi: 10.1186/s13027-020-00339-y.
- Struyf T, Deeks JJ, Dinnes J, Takwoingi Y, Davenport C, Leeflang MM, et al. Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID-19. Cochrane Database Syst Rev. 2021;2(2):CD013665. doi: 10.1002/14651858.CD013665.pub2.
- Dai H, Zhou H, Sun Y, Xu Z, Wang S, Feng T, et al. D-dimer as a potential clinical marker for predicting metastasis and progression in cancer. Biomed Rep. 2018;9(5):453-7. doi: 10.3892/br.2018.1151.
- Huang I, Pranata R. Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis. J Intensive Care. 2020;8(1):1-10.
- Ahnach M, Zbiri S, Nejjari S, Ousti F, Elkettani C. C-reactive protein as an early predictor of COVID-19 severity. J Med Biochem. 2020;39(4):500-7. doi: 10.5937/jomb0-27554.
- Gallo Marin B, Aghagoli G, Lavine K, Yang L, Siff EJ, Chiang SS, et al. Predictors of COVID-19 severity: A literature review. Rev Med Virol. 2021;31(1):1-10. doi: 10.1002/rmv.2146.
- Cattaneo C, Daffini R, Pagani C, Salvetti M, Mancini V, Borlenghi E, et al. Clinical characteristics and risk factors for mortality in hematologic patients affected by COVID-19. Cancer. 2020;126(23):5069-76. doi: 10.1002/cncr.33160.
- Booth S, Willan J, Wong H, Khan D, Farnell R, Hunter A, et al. Regional outcomes of severe acute respiratory syndrome coronavirus 2 infection in hospitalised patients with haematological malignancy. Eur J Haematol. 2020;105(4):476-83. doi: 10.1111/ejh.13469.
- Sanchez-Pina JM, Rodríguez Rodriguez M, Castro Quismondo N, Gil Manso R, Colmenares R, Gil Alos D, et al. Clinical course and risk factors for mortality from COVID-19 in patients with haematological malignancies. Eur J Haematol. 2020;105(5):597-607. doi: 10.1111/ejh.13493.
- Wang B, Van Oekelen O, Mouhieddine TH, Del Valle DM, Richter J, Cho HJ, et al. A tertiary center experience of multiple myeloma patients with COVID-19: lessons learned and the path forward. J Hematol Oncol. 2020;13(1):94. doi: 10.1186/s13045-020-00934-x.
)