尽管多发性骨髓瘤（MM）患者的存活率有所提高，但仍然难以治愈，经过蛋白酶抑制剂、免疫调节药物和抗CD38单克隆抗体治疗后，患者的总体存活期仅为数月。对MM的免疫病理学的更好理解导致了新的治疗靶点如B细胞成熟抗原（BCMA）的发现。BCMA是一种肿瘤坏死因子受体超家族，表达于正常B淋巴细胞和恶性浆细胞上，对正常和恶性浆细胞的增殖、成熟和分化起至关重要的作用。抗体药物结合物、嵌合抗原受体（CAR）T细胞和双特异性T细胞结合剂针对BCMA抗原现已在临床试验内外用于治疗三重分类难治性MM。本综述文章着重探讨BCMA定向CAR T细胞疗法的演变、安全性、疗效和限制，并讨论这些CAR T细胞在MM治疗范式中引入的挑战，以及CAR T细胞疗法在MM中的未来前景。版权所有©2023作者。Elsevier Inc.保留所有权利。

Despite continued advances that have led to improved survival of patients with multiple myeloma (MM) over the years, MM remains largely incurable with overall survival in patients who have progressed after proteasome inhibitor, immunomodulatory drug, and anti-CD38 monoclonal antibody therapy measured in months. Better understanding of the immunopathology of MM has led to the discovery of newer treatment targets like B-cell maturation antigen (BCMA). BCMA is a tumor necrosis factor receptor superfamily expressed on normal B-lymphocytes and malignant plasma cells with a vital role in proliferation, maturation, and differentiation of normal and malignant plasma cells. Antibody drug conjugates, chimeric antigen receptor (CAR) T-cells and bispecific T-cell engagers targeting the BCMA antigen are now available within and outside of clinical trials for treatment of triple class refractory MM. This review article focuses on the evolution, safety, efficacy, and limitations of BCMA-directed CAR T-cell therapies. It also discusses the challenges unveiled by the incorporation of these CAR T-cells in the treatment paradigm of MM and deliberates on the future of CAR T-cell therapy within MM.Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.