Cai Linyu, Zuo Liping, Wang Guangqi, Li Qun, Ma Chi, Wu Jianghua, Sun Chunyan, Hu Yu
Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, People's Republic of China.
Key Laboratory of Biological Targeted Therapy (Huazhong University of Science and Technology), Ministry of Education, Wuhan, Hubei, 430022, People's Republic of China.
Immunotargets Ther. 2025 Sep 11;14:997-1014. doi: 10.2147/ITT.S534784. eCollection 2025.
Multiple myeloma (MM) is a kind of plasma cell hematologic malignancy. Notable advancements in patient survival have been achieved due to the clinical application of anti-CD38 monoclonal antibody, chimeric antigen receptor T cells (CAR-T) and bispecific T cell engagers (TCEs). However, the immunosuppressive microenvironment of the bone marrow hinders the effectiveness of these novel immunotherapies, consequently restricting their efficacy. Hence, it is imperative to clarify the exact mechanisms to devise strategies aimed at improving the efficacy of immunotherapy. In this review, we provide a systematic overview of recent research concerning the different T cell subtypes in the immune evasion mechanisms of MM. The review emphasizes the imbalance between the immune surveillance and the immune suppression, and highlight recent studies about unconventional T cells, the metabolic control of immune reactions, and novel therapeutic strategies aimed at addressing immune evasion mechanisms that promote the progression of MM.
多发性骨髓瘤（MM）是一种浆细胞血液系统恶性肿瘤。由于抗CD38单克隆抗体、嵌合抗原受体T细胞（CAR-T）和双特异性T细胞衔接器（TCE）的临床应用，患者生存率有了显著提高。然而，骨髓的免疫抑制微环境阻碍了这些新型免疫疗法的有效性，从而限制了它们的疗效。因此，必须阐明确切机制，以制定旨在提高免疫治疗疗效的策略。在本综述中，我们系统概述了近期关于MM免疫逃逸机制中不同T细胞亚群的研究。该综述强调了免疫监视与免疫抑制之间的失衡，并重点介绍了关于非常规T细胞、免疫反应的代谢控制以及旨在解决促进MM进展的免疫逃逸机制的新型治疗策略的最新研究。
