髓外多发性骨髓瘤的发病机制和治疗进展  

The Pathogenesis and Treatment Progress of Extramedullary Multiple Myeloma---Review

作　　者：张钰琪 景红梅[1] ZHANG Yu-Qi;JING Hong-Mei(Department of Hematology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院血液科,北京100191

出　　处：《中国实验血液学杂志》2025年第2期612-615,共4页Journal of Experimental Hematology

基　　金：国家临床重点专科建设项目(2023)专项资金。

摘　　要：髓外病变是多发性骨髓瘤的独立预后因素。与不伴髓外病变相比,伴有髓外病变的多发性骨髓瘤有着不同的遗传学特点,更高发的高危染色体异常、更复杂的基因组谱以及与粘附和趋化因子分子表达相关的免疫表型特征。骨髓瘤细胞与肿瘤微环境的相互调控,包括免疫环境的改变、细胞外基质的沉积、粘附因子的异常表达、骨髓瘤细胞自分泌等,参与了骨髓瘤细胞的髓外迁移。各种免疫靶向治疗改善了髓外多发性骨髓瘤的预后。本文就髓外多发性骨髓瘤的遗传特征、肿瘤微环境的重要作用以及治疗的最新研究进展作一综述。Extramedullary disease(EMD)is an independent prognostic factor for multiple myeloma(MM).Compared with MM without EMD,MM with EMD has different genetic characteristics,with a higher incidence of high-risk chromosomal abnormalities,more complex genomic profile,and immunophenotypic features related to adhesion molecule and chemokine expression.The mutual regulation between myeloma cells and tumor microenvironment,including changes in immune environment,deposition of extracellular matrix,abnormal expression of adhesion molecules,and autocrine secretion of myeloma cells,is involved in the extramedullary migration of myeloma cells.Various immune-targeted therapies have improved the prognosis of extramedullary MM(EMM).This article reviews the genetic characteristics of EMM,important role of tumor microenvironment,and progress of treatment.

关 键 词：髓外病变 遗传特征 肿瘤微环境 免疫靶向治疗 

分 类 号：R733.3[医药卫生—肿瘤]