Multiple myeloma (MM) is a complex and heterogeneous hematologic malignancy characterized by clonal evolution, genetic instability, and interactions with a supportive tumor microenvironment. These factors contribute to treatment resistance, disease progression, and significant variability in clinical outcomes among patients. This review explores the mechanisms underlying MM progression, including the genetic and epigenetic changes that drive clonal evolution, the role of the bone marrow microenvironment in supporting tumor growth and immune evasion, and the impact of genomic instability. We highlight the critical insights gained from single-cell technologies, such as single-cell transcriptomics, genomics, and multiomics, which have enabled a detailed understanding of MM heterogeneity at the cellular level, facilitating the identification of rare cell populations and mechanisms of drug resistance. Despite the promise of advanced technologies, MM remains an incurable disease and challenges remain in their clinical application, including high costs, data complexity, and the need for standardized bioinformatics and ethical considerations. This review emphasizes the importance of continued research and collaboration to address these challenges, ultimately aiming to enhance personalized treatment strategies and improve patient outcomes in MM.
多发性骨髓瘤（MM）是一种复杂且异质性的血液系统恶性肿瘤，其特征包括克隆演化、遗传不稳定性以及与支持性肿瘤微环境的相互作用。这些因素导致患者出现治疗抵抗、疾病进展及临床结局的显著差异。本综述探讨了MM进展的潜在机制，包括驱动克隆演化的遗传和表观遗传改变、骨髓微环境在支持肿瘤生长和免疫逃逸中的作用，以及基因组不稳定性的影响。我们重点阐述了单细胞技术（如单细胞转录组学、基因组学和多组学分析）带来的关键见解，这些技术使人们能够在细胞水平上深入理解MM的异质性，有助于识别罕见细胞群体和耐药机制。尽管先进技术展现出巨大潜力，但MM仍是一种无法治愈的疾病，其临床应用仍面临诸多挑战，包括高昂成本、数据复杂性、标准化生物信息学分析的需求以及伦理考量。本综述强调持续研究和合作应对这些挑战的重要性，最终目标是为MM患者制定更精准的个体化治疗策略并改善临床预后。
肿瘤(癌症)患者之家