由于蛋白酶体抑制剂、免疫调节药物和抗体药物等创新治疗药物的出现，多发性骨髓瘤（MM）的预后近年来得到了显着改善。然而，患有治疗抵抗和髓外疾病的多发性骨髓瘤患者的预后仍然较差。骨髓微环境中MM细胞与其周围细胞之间的相互作用对于耐药性的发展至关重要。许多问题不能用液体因素来解释，例如细胞因子和趋化因子。细胞外囊泡（EV）因其在多种癌症进展中的作用而引起人们的兴趣。在本文中，我们主要总结了 MM 耐药性，并研究了有关导致 MM 耐药性获得的小 EV（特别是外泌体）的最新文章。

Because of innovative therapeutic agents such as proteasome inhibitors, immunomodulatory medicines, and antibody medications, the prognosis of multiple myeloma (MM) has considerably improved in recent years. However, the prognosis for MM patients with treatment resistance and extramedullary illness remains poor. The interaction between MM cells and their surrounding cells in the bone marrow microenvironment is critical for medication resistance development. Many issues cannot be explained by liquid factors, such as cytokines and chemokines. Extracellular vesicles (EVs) have gained interest due to their role in the advancement of several forms of cancers. In this article, we primarily summarize MM drug resistance and examine the most recent articles on small-EVs (particularly exosomes) that contribute to MM drug resistance acquisition.