Published on May 27, 2020
Health officials have stressed since the beginning of the recent novel coronavirus outbreak that older people and those with underlying health conditions are at higher risk.
A CDC report released in April stated that 90 percent of those hospitalized for the disease in the U.S. had at least one underlying health condition. It’s an alarming statistic particularly for patients with myeloma, according to Dr. Robert Orlowski, head of the myeloma program at The University of Texas MD Anderson Cancer Center in Houston, Texas.
“The recommendation is to make patients aware of their vulnerability and stress the need to help in terms of preventing infection, which is the best that we can do right now,” Dr. Orlowski told Patient Power Co-Founder Andrew Schorr in a recent “Ask the Expert” program.
No specific studies have been conducted to assess the risk of myeloma patients with regard to the virus that causes COVID-19, Dr. Orlowski said. But considering myeloma patients have shown to be more susceptible to viral illnesses such as the flu in the winter, extra precautions should be taken.
“Social distancing is the key here for all people, but especially for myeloma patients,” he said. “Try to limit social gatherings and wear masks in crowded areas. If you're going outside to take a walk, then that's not really necessary.”
Dr. Orlowski suggests patients with myeloma, a cancer of the white plasma cells in bone marrow, limit their exposure by not only restricting person-to-person contact with members of the general public as much as possible, but with their doctor and other healthcare providers as well.
“I think, first of all, as many visits as possible should be converted either to telephone visits or to telemedicine visits with your physician or other healthcare provider,” he said.
Additional steps, such as adjusting treatment or therapy, may also need to be considered to reduce potential infection.
“Therapeutic decisions should be made on an individual basis and consider things like newly diagnosed, relapsed/refractory and high-risk versus standard risk,” Dr. Orlowski said. “On a therapy perspective, I do think it's reasonable to look at each individual case, because some people will need to continue on the therapy that they're getting right now.”
He said for example, if somebody has relapsed/refractory disease that is symptomatic and was recently switched to a new therapy, the person may need to consider continuing that therapy to reduce the amount of disease burden.
“But in cases where it's feasible, I do think it's valuable to switch to less frequent treatment as long as that doesn't compromise efficacy,” he said.
One way to reduce treatment visits and the potential exposure of the coronavirus for myeloma patients is to change therapies. Oral therapies can be self-administered as opposed to an injection, which is usually administered by a medically trained specialist.
“In some cases, if someone is on the combination of an oral and an IV or an oral and a subcutaneous therapy, it may be reasonable to consider just staying on the oral for the next few months and holding the IV or subcutaneous,” Dr. Orlowski said.
He continued: “I do think that switching or using an all oral regimen for at least the next few months would be very wise, as long as the clinical scenario allows that. Again, there are people that have high disease burden and are symptomatic. Although, as always, consult with your local myeloma expert, because he or she will know your disease better.”
Dr. Orlowski said he is confident that there will be more data moving forward regarding myeloma and coronavirus. But he cautioned that a report on only a handful of cases may not be representative of what's really going on.
“Sadly, as you all know, there are many people in the United States with coronavirus,” he said. “And, unfortunately, some of those will be people with myeloma, and that will inform a little bit what we will do moving forward.”
Watch Dr. Orlowski’s “Ask the Expert” interview and read the transcript: Are Myeloma Treatment Plans Changing During Coronavirus?
Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.
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