伴髓外病变的多发性骨髓瘤发病机制的研究进展

Research progresses in the pathogenesis of multiple myeloma with extramedullary disease

多发性骨髓瘤(MM)是一种恶性浆细胞疾病,其特征是单克隆浆细胞无限增殖、广泛浸润骨髓。在初诊时或在诊治过程中出现髓外病变(EMD)的MM,被称为伴髓外病变的多发性骨髓瘤(EMM)。其中,伴血源播散浆细胞瘤的EMM在生物学及临床上具有明显异质性,该类患者预后极差。目前研究认为,EMM的发病机制与肿瘤的细胞遗传学异常,骨髓微环境中黏附分子、趋化因子受体、细胞因子表达异常及外泌体等密切相关。笔者重点就EMM发病机制进行综述,旨在探究EMM异质性的原因。

Multiple myeloma (MM) is a plasma cell malignant disease which is characterized by unlimited proliferation of monoclonal plasma cells and multiple infiltration of the bone marrow. Extramedullary myeloma (EMM) is found in some MM patients with extramedullary disease (EMD) at the initial diagnosis or during treatment. Particularly the hematogenous EMM has great heterogeneity and possesses poor prognosis in clinical applications. In general, the mechanism of EMM is closely related to cytogenetic abnormalities, the changes of the adhesion molecules, chemokine receptors, abnormal cytokine expression and exosomes etc. in bone marrow microenvironment. The authors focuses on the pathogenesis of EMM, in order to explore the causes of EMM heterogeneity.