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目的:分析初诊双打击多发性骨髓瘤(MM)的临床特点及治疗反应。方法:应用原位荧光杂交技术(FISH)检测西南医科大学附属医院2015年1月至2019年6月初诊MM患者146例1q21扩增及17p缺失情况，收集患者临床资料，国际分期系统(ISS)分期Ⅲ期合并1q21扩增和/或17p缺失定义为双打击MM组，共42例，非双打击MM组104例。对患者的临床指标进行相关性分析。结果:双打击组βn 2-微球蛋白、乳酸脱氢酶、肌酐、血钙、骨髓浆细胞比例、国际骨髓瘤工作组分组高危型者比例均较非双打击组高，两组差异均有统计学意义(n Z＝－6.636、－3.789、－5.116，n t＝2.288，n Z＝－5.091，χn 2＝32.489，均n P<0.05)；双打击组患者的血红蛋白为(75.14±20.65)g/L，低于非双打击组的(88.21±26.31)g/L(n t＝－3.187，n P＝0.002)。146例患者的4年生存率为42.7%，非双打击患者的4年生存率为51.4%，双打击组患者的4年生存率为13.6%，两组差异有统计学意义(n Z＝4.000，n P0.05)。n 结论:与非双打击相比，双打击MM患者的临床表现更严重，4年生存率更低，硼替佐米可能无法改善双打击MM患者的预后。“,”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 n 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(n Z=-6.636, -3.789, -5.116, n t=2.288, n Z=-5.091, χ n 2=32.489, all n 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](n t=-3.187, n 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 (n Z=4.000, n 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.n 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.