多发性骨髓瘤骨髓微环境及治疗策略综述
A Review of the Bone Marrow Microenvironment and Therapeutic Strategies in Multiple Myeloma
DOI: 10.12677/acm.2025.1561691, PDF,   
作者: 曾庆宏：吉首大学株洲临床学院，湖南 湘西；沈婵娟*：株洲市中心医院血液内科，湖南 株洲
关键词: 多发性骨髓瘤；骨髓微环境；免疫治疗；Multiple Myeloma； Bone Marrow Microenvironment； Immunotherapy
摘要: 作为一种浆细胞异常增殖的恶性肿瘤，多发性骨髓瘤(multiple myeloma, MM)呈现出显著的病理异质性。在疾病发生发展机制中，骨髓免疫微环境(bone marrow microenvironment, BMME)扮演着关键调控角色。针对该微环境的干预措施主要包括：蛋白酶体抑制类药物(如硼替佐米、卡非佐米及伊沙佐米)、免疫调节制剂(如来那度胺与沙利度胺)以及新型生物治疗手段。后者涵盖单克隆抗体疗法(以达雷妥尤单抗和埃罗妥珠单抗为代表)和嵌合抗原受体T细胞(CAR-T)技术，这些创新性治疗方案的临床应用极大地提升了患者的远期生存质量。本综述探讨MM骨髓微环境的作用机制及其相关治疗策略的最新进展，以期为临床实践提供理论依据。
Abstract: As a malignant tumor characterized by clonal proliferation of plasma cells, multiple myeloma (MM) exhibits remarkable pathological heterogeneity. In the mechanisms of pathogenesis and disease progression, the bone marrow immune microenvironment (BMME) plays a pivotal regulatory role. Interventions targeting this microenvironment include proteasome inhibitors (such as bortezomib, carfilzomib, and ixazomib), immunomodulatory agents (including lenalidomide and thalidomide), and novel biologic therapeutics. The latter category encompasses monoclonal antibody therapies (represented by daratumumab and erlotuzumab) and chimeric antigen receptor T-cell (CAR-T) technology. The clinical application of these innovative therapeutic regimens has substantially enhanced the long-term survival quality of patients. This review examines recent advances in understanding the mechanisms of action of the MM bone marrow microenvironment and its associated therapeutic strategies, aiming to provide a theoretical foundation for clinical practice.
文章引用：曾庆宏, 沈婵娟. 多发性骨髓瘤骨髓微环境及治疗策略综述[J]. 临床医学进展, 2025, 15(6): 1-7. https://doi.org/10.12677/acm.2025.1561691

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