TY - JOUR
T1 - Delayed diagnosis resulting in increased disease burden in multiple myeloma
T2 - the legacy of the COVID-19 pandemic
AU - Carmichael, Jonathan
AU - Seymour, Frances
AU - McIlroy, Graham
AU - Tayabali, Sarrah
AU - Amerikanou, Rosie
AU - Feyler, Sylvia
AU - Popat, Rakesh
AU - Pratt, Guy
AU - Parrish, Christopher
AU - Ashcroft, A John
AU - Jackson, Graham H
AU - Cook, Gordon
N1 - © 2023. The Author(s).
PY - 2023/3/15
Y1 - 2023/3/15
N2 - The COVID-19 pandemic has had global healthcare impacts, including high mortality from SARS-CoV-2 infection in cancer patients; individuals with multiple myeloma (MM) are especially susceptible to poor outcomes. However, even for MM patients who avoided severe infection, the ramifications of the pandemic have been considerable. The consequences of necessary socio-geographical behavior adaptation, including prolonged shielding and interruptions in delivery of non-pandemic medical services are yet to be fully understood. Using a real-world dataset of 323 consecutive newly diagnosed MM patients in England, we investigated the impact of the COVID-19 pandemic on routes to myeloma diagnosis, disease stage at presentation and relevant clinical outcomes. We demonstrate increasing MM presentations via emergency services and increased rates of bony and extra-medullary disease. Differences were seen in choice of induction therapy and the proportion of eligible patients undertaking autologous stem cell transplantation. Whilst survival was statistically inferior for emergency presentations, significant survival differences have yet to be demonstrated for the entire cohort diagnosed during the pandemic, making extended follow-up critical in this group. This dataset highlights wide-ranging issues facing MM patients consequent of the COVID-19 pandemic, with full impacts for clinicians and policy-makers yet to be elucidated.
AB - The COVID-19 pandemic has had global healthcare impacts, including high mortality from SARS-CoV-2 infection in cancer patients; individuals with multiple myeloma (MM) are especially susceptible to poor outcomes. However, even for MM patients who avoided severe infection, the ramifications of the pandemic have been considerable. The consequences of necessary socio-geographical behavior adaptation, including prolonged shielding and interruptions in delivery of non-pandemic medical services are yet to be fully understood. Using a real-world dataset of 323 consecutive newly diagnosed MM patients in England, we investigated the impact of the COVID-19 pandemic on routes to myeloma diagnosis, disease stage at presentation and relevant clinical outcomes. We demonstrate increasing MM presentations via emergency services and increased rates of bony and extra-medullary disease. Differences were seen in choice of induction therapy and the proportion of eligible patients undertaking autologous stem cell transplantation. Whilst survival was statistically inferior for emergency presentations, significant survival differences have yet to be demonstrated for the entire cohort diagnosed during the pandemic, making extended follow-up critical in this group. This dataset highlights wide-ranging issues facing MM patients consequent of the COVID-19 pandemic, with full impacts for clinicians and policy-makers yet to be elucidated.
KW - Humans
KW - COVID-19/epidemiology
KW - Multiple Myeloma/diagnosis
KW - SARS-CoV-2
KW - Pandemics
KW - Hematopoietic Stem Cell Transplantation
KW - Delayed Diagnosis
KW - Transplantation, Autologous
KW - COVID-19 Testing
U2 - 10.1038/s41408-023-00795-w
DO - 10.1038/s41408-023-00795-w
M3 - Article
C2 - 36922489
SN - 2044-5385
VL - 13
JO - Blood Cancer Journal
JF - Blood Cancer Journal
IS - 1
M1 - 38
ER -