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.
COVID-19大流行对全球医疗体系产生了深远影响，其中癌症患者因SARS-CoV-2感染导致的高死亡率尤为突出；多发性骨髓瘤患者尤其容易出现不良临床结局。然而，即使对于未发生严重感染的骨髓瘤患者，疫情带来的连锁反应仍不容忽视。必要的社交与地域行为调整（包括长期隔离防护以及非疫情相关医疗服务的中断）所产生的影响尚未被完全认知。基于英格兰地区连续323例新诊断多发性骨髓瘤患者的真实世界数据，我们研究了COVID-19大流行对骨髓瘤诊断途径、初诊时疾病分期及相关临床结局的影响。数据显示，经急诊途径确诊的骨髓瘤病例增多，骨病变及髓外病变发生率上升。在诱导治疗的选择以及适合患者接受自体干细胞移植的比例方面亦存在差异。虽然急诊就诊患者的生存率在统计学上较差，但就整个疫情期间确诊的患者队列而言，显著的生存差异尚未完全显现，这使得延长随访期对该群体至关重要。本数据集揭示了COVID-19大流行给多发性骨髓瘤患者带来的广泛性问题，其对临床医生和政策制定者的全面影响仍有待阐明。
肿瘤(癌症)患者之家