何佳丽,熊 华

多发性骨髓瘤（multiplemyeloma，MM）是一种起源于骨髓浆细胞的恶性血液系统疾病，免疫轻瘫作为其常见的伴随免疫功能紊乱状态，以未受累免疫球蛋白水平显著降低为核心特征，直接影响患者感染风险、治疗效果及预后。本文系统综述免疫轻瘫在MM患者中的发病机制、临床特征、诊断标准、与疾病进展的关联及治疗策略的研究进展，重点分析硼替佐米-来那度胺-地塞米松（VRD）等诱导治疗方案对免疫轻瘫的逆转作用及免疫替代治疗的应用价值，并探讨免疫轻瘫作为预后评估指标的临床意义，为MM患者的个体化治疗及免疫功能管理提供参考。

多发性骨髓瘤；免疫轻瘫；发病机制；治疗进展；预后

[1] 杨宝,任赵娟,王尧.伊沙佐米联合来那度胺及地塞米松对复发难治性多发性骨髓瘤患者免疫功能的影响[J].贵州医药,2025, 49(10):1552-1554. [2] 马建苗,刘静,徐杰琳,等.影响多发性骨髓瘤患者骨质疏松性骨折发生的独立危险因素及风险预测模型构建[J].转化医学杂志, 2025,14(10):97-101. [3] 金伟媚,王晓丽,江妤,等.血乳酸与白蛋白比值与多发性骨髓瘤伴脓毒症患者预后的相关性分析[J].浙江中西医结合杂志, 2025,35(10):931-935. [4] 汪想,马邦云,宋竞择,等.多发性骨髓瘤合并肾损伤中西医结合治疗研究进展[J/OL].实用中医内科杂志,1-5[2025-10-22]. [5] Banerjee R,Kaur G,Razzo M B,et al.Predictors of Delayed Responses to Teclistamab in Multiple Myeloma After Initial Non-Response. [J].American journal of hematology,2025 [6] 侯俊芳,王亚敏,王怡文.疾病进展恐惧对多发性骨髓瘤患者化疗症状困扰的影响[J].航空航天医学杂志,2025,36(10):1241-1244. [7] 李硕,王茜茜,聂淑敏,等.含达雷妥尤单抗联合方案治疗初治高危IgM型多发性骨髓瘤患者1例并文献复习[J].现代肿瘤医学, 2025,33(11):1909-1915. [8] 张文娴,王凯丰.BCL-2抑制剂治疗多发性骨髓瘤的进展研究[J].中国现代药物应用,2025,19(21):173-176. [9] Cho Y,Yoo Y.Factors associated with meaning in life of patients with multiple myeloma in Korea.[J].Psychology,health&medicine, 2025,1-16. [10] An G,Jin J,Cai Z,et al.Talquetamab,a GPRC5D×CD3 bispecific antibody,in Chinese patients with relapsed/refractory multiple myeloma:efficacy and safety from the phase 1/2 MonumenTAL-1 study.[J].Haematologica,2025, [11] 闫红霞.心理干预与安宁疗护在多发性骨髓瘤中的应用[J].中国冶金工业医学杂志,2025,42(05):560-562. [12] 徐菁,王惠,陈洁.循证预防护理在多发性骨髓瘤患者中的应用效果观察[J].医药前沿,2025,15(28):126-129. [13] Abissi W P,Lymperopoulou G,Agrokostas P V,et al.Evaluation of cumulative radiation burden and associated risk in smouldering multiple myeloma patients monitored using recurrent whole-body low-dose CT imaging.[J].Physica medica:PM:an international journal devoted to the applications of physics to medicine and biology:official journal of the Italian Association of Biomedical Physics (AIFB),2025,138 105173. [14] Bahlis J N,Zonder J,Karlin L,et al.Subcutaneous daratumumab plus carfilzomib and dexamethasone(D-Kd)versus carfilzomib and dexamethasone(Kd)in patients with relapsed/refractory multiple myeloma who received previous daratumumab treatment:LYNX study.[J].Leukemia&lymphoma,2025,1-12. [15] Tokuhira M,Nakayama H,Toyama K,et al.Investigation of early mortality in the patients with newly diagnosed multiple myeloma:insights from a real-world cohort using J-CHAEGE-MM database[J].International Journal of Hematology,2025,(prepublish):1-14. [16] Manier S,Lambert J,Hulin C,et al.Safety and efficacy of a dexamethasone-sparing regimen with daratumumab and lenalidomide in patients with frailty and newly diagnosed multiple myeloma(IFM2017-03):a phase 3,open-label,multicentre,randomised,controlled trial[J].The Lancet Oncology,2025,26(10):1323-1333. [17] Sachpekidis C,Hajiyianni M,Grözinger M,et al.Validation of novel low-dose CT methods for quantifying bone marrow in the appendicular skeleton of patients with multiple myeloma:initial results from the[18F]FDG PET/CT sub-study of the Phase 3 GMMG-HD7 Trial[J].European Journal of Nuclear Medicine and Molecular Imaging,2025,(prepublish):1-12. [18] Lin Z,Dong R,Zhang W,et al.Efficacy and safety of anti-CD38 monoclonal antibodies in patients with newly diagnosed multiple myeloma:an updated systematic review and meta-analysis based on randomized controlled trials.[J].Leukemia&lymphoma,2025,66(10):1839-1849. [19] Bruins C S W,Smits F,Duetz C,et al.Immune signatures in older patients with newly diagnosed multiple myeloma are associated with survival outcomes of first-line therapy irrespective of frailty levels.[J].HemaSphere,2025,9(10):e70210. [20] Jin L,Gu S,Ruan Q,et al.GPRC5D-targeted CAR T-cell therapy(CT071)in patients with relapsed or refractory multiple myeloma:a first-in-human,single-centre,single-arm,phase 1 trial.[J].The Lancet.Haematology,2025,12(10):e798-e807. [21] Shain H K.More is not always more for older patients with multiple myeloma[J].The Lancet Oncology,2025,26(10):1263-1265. [22] Donk D V J C W N,Chari A,Martin T,et al.Characterization and Management of Cytokine Release Syndrome From the MonumenTAL- 1 Study of Talquetamab in Patients With Relapsed/Refractory Multiple Myeloma.[J].Cancer medicine,2025,14(19):e71276. [23] Hamdeh A N,Alnees M,Ewidat O,et al.Predictors of quality of life in multiple myeloma patients:a multi-centered cross-sectional study[J].BMC Cancer,2025,25(1):1472-1472. [24] Chen W,Fu C,Fang B,et al.Phase II study of zevorcabtagene autoleucel,a fully human BCMA-targeting CAR T cell therapy,in patients with relapsed/refractory multiple myeloma[J].Experimental Hematology&Oncology,2025,14(1):119-119. [25] 王素娟,李梦娟.硼替佐米联合来那度胺和重组人促红细胞生成素治疗多发性骨髓瘤的疗效及安全性对比分析[J].医药论坛杂志, 2025,46(18):1966-1969+1974. [26] 杜彦艳,李洁,周文烨,等.多指标联合检测对多发性骨髓瘤早期肾损伤患者的诊断及预后评估价值[J].癌变·畸变·突变,2025, 37(05):389-392+399. [27] Park H,Robinson J,Flanagan C,et al.The risk of second primary malignancies in patients receiving T-cell directed therapies for multiple myeloma:a systematic review.[J].Leukemia&lymphoma,2025,1-10. [28] Lu R,Ling H,Huang Z,et al.Development of a prediction model for lower limb deformity in patients with hereditary multiple exostoses based on interpretable models and nomogram[J].BMC Medical Informatics and Decision Making,2025,25(1):355-355. [29] Mian S H,Harper S J,Le H H,et al.Real-World Treatment Patterns and Clinical Outcomes Among Patients With Triple-Class-Exposed and BCMA-Exposed Multiple Myeloma Within the United States.[J].EJHaem,2025,6(5):e70145. [30] Wu W,Wang Y,Wu Y,et al.Health-related quality of life and financial toxicity in Chinese patients with multiple myeloma:a two-year real-world multicentre study[J].Health and Quality of Life Outcomes,2025,23(1):87-87.

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