2024 年第 10 期 第 19 卷

多发性骨髓瘤免疫微环境及免疫治疗概述

Overview of immune microenvironment and immunotherapy in multiple myeloma

作者：沈子悦陈建斌

英文作者：Shen Ziyue Chen Jianbin

单位：重庆医科大学附属第一医院血液内科，重庆400016

英文单位：Department of Hematology the First Affiliated Hospital of Chongqing Medical University Chongqing 400016 China

关键词：多发性骨髓瘤；骨髓微环境；免疫细胞；外泌体；免疫治疗

英文关键词：Multiplemyeloma；Bonemarrowmicroenvironment；Immunecells；Exosomes；Immunotherapy

• 摘要：

• 多发性骨髓瘤（MM）目前无法治愈，随着新药联合自体移植的高速发展，患者中位总生存期接近10年，但因MM具有高度异质性，仍有部分患者预后差，生存期较短。骨髓微环境在MM中发挥着重要作用。侵袭性血管的生成、调节性免疫细胞、外泌体、自噬等均可影响骨髓微环境，促进MM进展及耐药的发生。本文主要对MM免疫微环境中各组分的相互作用及免疫治疗展开综述，以期提供更多新的治疗策略。

• Multiple myeloma (MM) cannot be cured at present. With the rapid development of new drugs combined with autologous transplantation, the median overall survival of patients is nearly 10 years. However, due to the high heterogeneity of MM, there are still some patients with poor prognosis and short survival. Bone marrow microenvironment plays an important role in MM. The formation of invasive vessels, regulatory immune cells, exosomes and autophagy, etc. can all affect the bone marrow microenvironment and promote the progression and drug resistance of MM. This review focuses on the interaction of components in the immune microenvironment of MM and immunotherapy, in order to provide more new treatment strategies.