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. Issue 1 (31st December 2022)

• Record Type: Journal Article
• Authors: Djebbari, Faouzi; Rampotas, 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
• Is Part Of: Hematology. Volume 27:Issue 1(2022)
• Page Start: 691
• Page End: 699
• Publication Date: 2022-12-31
• Subjects: Infections -- isatuximab -- pomalidomide -- real-world -- myeloma; Blood -- Diseases -- Periodicals; Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; 616.15005
• DOI: 10.1080/16078454.2022.2082725
• Languages: English
• ISSNs: 1024-5332

Abstract

ABSTRACT: 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.