Analysis of the clinical features and response to therapies of double hit multiple myeloma / 中国基层医药

ABSTRACT

Objective:To analyze the clinical features and response to therapies of double hit multiple myeloma(MM) and non-double hit MM.Methods:The fluorescent in situ hybridization (FISH) was used for detection of del(17p13) and gain(1q21), the definition of double hit MM was international staging system Ⅲ plus gain(1q21) and(or) del(17p13). The clinical data of 146 newly diagnosed MM patients in the Affiliated Hospital of Southwest Medical University from January 2015 to June 2019 were analyzed retrospectively.There were 42 patients with double hit MM, and 104 patients with non-double hit MM.Results:The ratio of β 2-microglobulin, LDH, creatinine, blood calcium, myeloplasma cell and the proportion of high-risk group in the international working group of myeloma in the double hit MM group were higher than those in the non double hit group, and the differences between the two groups were statistically significant( Z=-6.636, -3.789, -5.116, t=2.288, Z=-5.091, χ 2=32.489, all P<0.05). The HB level in the double hit group [(75.14±20.65)g/L] was lower than that in the non-double hit group [(88.21±26.31)g/L]( t=-3.187, P=0.002). The 4-year overall survival rate was 42.7% in 146 patients, 51.4% in the non-double-hit patients, and 13.6% in the double-hit patients, the difference between the two groups was statistically significant ( Z=4.000, P<0.001). Among the 42 double-hit patients, 19 patients were treated with the " traditional regimen" , with a 4-year overall survival rate of 12.3%, and 23 patients were treated with the " bortezomib regimen" , with a 4-year overall survival rate of 25.4%.There was no statistically significant difference in the overall survival rate between the two groups. Conclusion:Compared with the non-double hit group, the double hit group has more severe clinical manifestations and a lower 4-year overall survival rate.Bortezomib may not improve the prognosis of the double-hit group.