多发性骨髓瘤的耐药与下列因素有关:靶细胞内药物浓度降低;药物靶细胞的改变;抑制药物诱导的凋亡;尤其是后者,现越来越受到重视。已发现许多基因及其突变、细胞因子、细胞与细胞或与细胞外基质的粘附、骨髓血管生成的增加等许多因素均参与骨髓瘤细胞抵抗药物诱导的凋亡。 The resistance of multiple myeloma is related to the following factors: the decrease of drug concentration in target cells; the change of drug target cells; inhibition of drug-induced apoptosis; especially the latter, is increasingly receiving attention. Many factors, such as many genes and their mutations, cytokines, adhesion of cells or cells to extracellular matrix, and increase of angiogenesis in bone marrow, have been found to participate in myeloma cell resistance to drug-induced apoptosis.