Infections in relapsed myeloma patients treated with isatuximab plus pomalidomide and dexamethasone during the COVID-19 pandemic: Initial results of a UK-wide real-world study.
Author
Djebbari, FaouziRampotas, Alexandros
Vallance, Grant
Panitsas, Fotios
Basker, Nanda
Sangha, Gina
Salhan, Beena
Karim, Farheen
Firas, Al-Kaisi
Gudger, Amy
Ngu, Loretta
Poynton, Matt
Lam, Ho Pui Jeff
Morgan, Lowri
Yang, Laura
Young, Jennifer
Walker, Mairi
Tsagkaraki, Ismini
Anderson, Laura
Chauhan, Saleena Rani
Maddams, Rebecca
Soutar, Richard
Triantafillou, Margarita
Prideaux, Steve
Obeidalla, Abubaker
Eyre, Toby A
Bygrave, Ceri
Basu, Supratik
Ramasamy, Karthik
Publication date
2022-12-27Subject
Haematology
Metadata
Show full item recordAbstract
Objectives: There are no real-world data describing infection morbidity in relapsed/refractory myeloma (RRMM) patients treated with anti-CD38 isatuximab in combination with pomalidomide and dexamethasone (IsaPomDex). In this UK-wide retrospective study, we set out to evaluate infections experienced by routine care patients who received this novel therapy across 24 cancer centres during the COVID-19 pandemic. Methods: The primary endpoint was infection morbidity (incidence, grading, hospitalization) as well as infection-related deaths. Secondary outcomes were clinical predictors of increased incidence of any grade (G2-5) and high grade (≥G3) infections. Results: In a total cohort of 107 patients who received a median (IQR) of 4 cycles (2-8), 23.4% of patients experienced ≥1 any grade (G2-5) infections (total of 31 episodes) and 18.7% of patients experienced ≥1 high grade (≥G3) infections (total of 22 episodes). Median time (IQR) from start of therapy to first episode was 29 days (16-75). Six patients experienced COVID-19 infection, of whom 5 were not vaccinated and 1 was fully vaccinated. The cumulative duration of infection-related hospitalizations was 159 days. The multivariate (MVA) Poisson Regression analysis demonstrated that a higher co-morbidity burden with Charlson Co-morbidity Index (CCI) score ≥4 (incidence rate ratio (IRR) = 3, p = 0.012) and sub-optimal myeloma response less than a partial response (<PR) (p = 0.048) are independent predictors of ≥ G3 infections. Conclusion: Our study described initial results of infection burden during IsaPomDex treatment. We recommend close monitoring particularly in elderly patients with co-morbidities, the effective use of an-infective prophylaxis, as well as optimal vaccination strategies, to limit infections.Citation
Djebbari F, Rampotas A, Vallance G, Panitsas F, Basker N, Sangha G, Salhan B, Karim F, Firas AK, Gudger A, Ngu L, Poynton M, Lam HPJ, Morgan L, Yang L, Young J, Walker M, Tsagkaraki I, Anderson L, Chauhan SR, Maddams R, Soutar R, Triantafillou M, Prideaux S, Obeidalla A, Eyre TA, Bygrave C, Basu S, Ramasamy K. Infections in relapsed myeloma patients treated with isatuximab plus pomalidomide and dexamethasone during the COVID-19 pandemic: Initial results of a UK-wide real-world study. Hematology. 2022 Dec;27(1):691-699. doi: 10.1080/16078454.2022.2082725Type
ArticleAdditional Links
http://www.tandfonline.com/loi/yhem20PMID
35666686Journal
HematologyPublisher
Taylor and Francis Groupae974a485f413a2113503eed53cd6c53
10.1080/16078454.2022.2082725