微小残留病在多发性骨髓瘤中的应用进展与临床争议

Advances and Clinical Controversies in the Application of Minimal Residual Disease in Multiple Myeloma

摘要: 多发性骨髓瘤(multiple myeloma, MM)是骨髓内浆细胞异常增生所致的血液系统恶性肿瘤，具有异质性强、易复发等特点。随着多种新型药物的出现及治疗技术的更新，多数MM患者可获得临床缓解；但常规检测难以发现体内残存微量肿瘤细胞，即微小残留病(minimal residual disease, MRD)，而MRD正是导致复发的根源。近年来MRD在MM中的价值逐渐突显，但同时也存在诸多争议亟待解决。本文结合近年来国内外相关研究，系统综述MRD在MM中的实际价值并深入剖析当前存在的主要争议，探讨未来研究方向，为实现MM个体化精准治疗提供参考。

Abstract: Multiple myeloma (MM) is a hematologic malignancy characterized by abnormal proliferation of plasma cells in the bone marrow, with prominent features of high heterogeneity and frequent relapse. With the emergence of various novel agents and advances in therapeutic techniques, most patients with MM can achieve clinical remission. However, conventional detection methods fail to identify minimal residual tumor cells, namely minimal residual disease (MRD), which is the root cause of disease relapse. In recent years, the clinical value of MRD in MM has become increasingly evident, yet numerous controversies remain to be addressed. This article systematically reviews the practical value of MRD in MM based on recent domestic and international studies, deeply analyzes the major current controversies, and explores future research directions, aiming to provide a reference for the implementation of individualized precision therapy in MM.