多发性骨髓瘤（MM）是全球第二常见的血液恶性肿瘤，其特征是恶性浆细胞在容许肿瘤形成的骨髓微环境中异常增殖。新兴证据显示代谢紊乱是MM病理生物学中的关键决定因素。在本综述中，我们重点阐述了MM的代谢特征，展示了与各种脂类途径有关的变化，主要涉及脂肪酸、胆固醇和鞘脂，它们如何影响MM细胞的生长、存活和药物反应性，以及它们与肿瘤微环境中其他细胞成分的相互作用。这些发现将为了解脂质易感性是如何产生并影响恶性浆细胞表型提供一个新的路径，突出了一些具有重大影响的新的可靶向途径，对MM的管理具有重要意义。© 2023. The Author(s).

Multiple myeloma (MM) is the second most common hematological malignancy worldwide, characterized by abnormal proliferation of malignant plasma cells within a tumor-permissive bone marrow microenvironment. Metabolic dysfunctions are emerging as key determinants in the pathobiology of MM. In this review, we highlight the metabolic features of MM, showing how alterations in various lipid pathways, mainly involving fatty acids, cholesterol and sphingolipids, affect the growth, survival and drug responsiveness of MM cells, as well as their cross-talk with other cellular components of the tumor microenvironment. These findings will provide a new path to understanding the mechanisms underlying how lipid vulnerabilities may arise and affect the phenotype of malignant plasma cells, highlighting novel druggable pathways with a significant impact on the management of MM.© 2023. The Author(s).