1
|
Carmichael J, Seymour F, McIlroy G, Tayabali S, Amerikanou R, Feyler S, Popat R, Pratt G, Parrish C, Ashcroft AJ, Jackson GH, Cook G. Delayed diagnosis resulting in increased disease burden in multiple myeloma: the legacy of the COVID-19 pandemic. Blood Cancer J 2023; 13:38. [PMID: 36922489 PMCID: PMC10015143 DOI: 10.1038/s41408-023-00795-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/11/2023] [Accepted: 01/30/2023] [Indexed: 03/17/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Jonathan Carmichael
- Leeds Institute of Clinical Trial research & Leeds Cancer Centre, University of Leeds, Leeds, UK
- NIHR Medtech & In Vitro Diagnostics Cooperative (Leeds), Leeds, UK
- Dept of Haematology, Leeds Cancer Centre, Leeds Teaching Hospitals Trust, Leeds, UK
| | - Frances Seymour
- Dept of Haematology, Leeds Cancer Centre, Leeds Teaching Hospitals Trust, Leeds, UK
| | - Graham McIlroy
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Sarrah Tayabali
- Dept of Haematology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Rosie Amerikanou
- Dept of Haematology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Sylvia Feyler
- Dept of Haematology, Calderdale & Huddersfield Foundation Trust, Huddersfield, UK
| | - Rakesh Popat
- Dept of Haematology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Guy Pratt
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Christopher Parrish
- Leeds Institute of Clinical Trial research & Leeds Cancer Centre, University of Leeds, Leeds, UK
- Dept of Haematology, Leeds Cancer Centre, Leeds Teaching Hospitals Trust, Leeds, UK
| | - A John Ashcroft
- Dept of Haematology, Pinderfields Hospital, Mid Yorkshire NHS Trust, Wakefield, UK
| | - Graham H Jackson
- Department of Haematology, Newcastle University, Newcastle, UK
- College of Myeloma (UK), London, UK
| | - Gordon Cook
- Leeds Institute of Clinical Trial research & Leeds Cancer Centre, University of Leeds, Leeds, UK.
- NIHR Medtech & In Vitro Diagnostics Cooperative (Leeds), Leeds, UK.
- Dept of Haematology, Leeds Cancer Centre, Leeds Teaching Hospitals Trust, Leeds, UK.
| |
Collapse
|
2
|
Sharpley FA, Larham J, Haines A, Djebbari F, Tseu B, Leary H, Vallance G, Panitsas F, Ferguson L, Roberts P, Peniket A, Gooding S, Kothari J, Moore S, Ramasamy K. Myeloma clinical outcomes following the first wave of COVID-19: results from the Thames Valley Cancer Alliance (UK). Br J Haematol 2020; 192:e136-e139. [PMID: 33326594 DOI: 10.1111/bjh.17261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/05/2020] [Accepted: 11/12/2020] [Indexed: 01/01/2023]
Affiliation(s)
- Faye A Sharpley
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
| | - Jemma Larham
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
| | - Angus Haines
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
| | - Faouzi Djebbari
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
| | - Bing Tseu
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
| | - Heather Leary
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
| | - Grant Vallance
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
| | - Fotios Panitsas
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
| | - Lisa Ferguson
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
| | - Pamela Roberts
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
| | - Andrew Peniket
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
| | - Sarah Gooding
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
| | - Jaimal Kothari
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
| | - Sally Moore
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
| | - Karthik Ramasamy
- Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, UK
| |
Collapse
|