Objective: To analyze and explore the clinical characteristics and prognosis of patients with "double hit" multiple myeloma (MM) . Methods: We retrospectively analyzed 89 MM patients in our department of Shanghai Changzheng Hospital from 2010-2016. All patients were assayed by fluorescence in situ hybridization (FISH) and TP53 gene sequencing, based on Dr. Walker BA proposed the "double hit" MM concept, and then the clinical features and prognosis were evaluated. Results: In the results, 15 (16.85%) cases harbored "double hit" showed the median PFS of 8.4 months and the median OS 22.2 months, which was significantly lower than non-"double hit" patients with median PFS 14.2 months and the median OS 39.2 months, respectively (P<0.05) . Multivariate analysis displayed that the "double hit" was an independent poor prognostic factor on PFS (HR=2.171, 95%CI 1.206-3.907, P=0.010) and OS (HR=4.106, 95%CI 2.116-7.969, P<0.001) . Moreover, "double hit" MM patients had the higher adverse prognosis risk, which showed the shorter median OS and PFS than stage III of R-ISS patients (PFS 8.4 vs 11.8 months; OS 22.2 vs 24.3 months, P<0.05, respectively) . Conclusion: Patients with "double hit" MM have a very poor clinical prognosis. Prospective clinical studies are urgently needed to improve these extra high risk patients.
目的： 分析并探讨"双打击"多发性骨髓瘤（MM）患者的临床特征及预后。 方法： 研究对象为2010-2016年第二军医大学长征医院诊断的89例MM患者，通过FISH检测染色体变化，基因测序检测TP53基因突变情况，根据最新Walker BA学者提出的"双打击"骨髓瘤定义，分析"双打击"MM患者的临床特征及预后。 结果： "双打击"MM患者15例（16.85%），中位无进展生存（PFS）时间（8.4个月）和中位总生存（OS）时间（22.2个月）较非"双打击"MM患者的中位PFS时间（14.2个月）和中位OS时间（39.2个月）显著降低（P均<0.05）。多因素预后风险分析显示，"双打击"是影响患者PFS（HR=2.171，95%CI 1.206~3.907，P=0.010）和OS（HR=4.106，95%CI 2.116~7.969，P<0.001）的独立预后不良因素，且"双打击"患者的中位PFS时间（8.4个月）和中位OS时间（22.2个月）分别较R-ISS Ⅲ期患者的中位PFS时间（11.8个月）和中位OS时间（24.3个月）显著缩短（P均<0.05）。 结论： "双打击"MM患者预后极差，亟待前瞻性临床研究改善此类患者预后。.
Keywords: Double hit; Multiple myeloma; Prognosis.