“双打击”多发性骨髓瘤患者的临床预后分析

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.