目的:探讨年轻多发性骨髓瘤(MM)患者(<50岁)的临床表现、实验室检查特点、疗效及生存情况。方法:回顾性分析24例(<50岁)MM患者的临床资料。结果:年轻MM患者占同期MM患者的10.1%(24/238),IgG型和轻链型为主,DS分期均为Ⅲ期,ISS分期Ⅰ期6例,Ⅱ期14例,Ⅲ期4例;8例出现髓外浸润;染色体核型异常(G带染色)4/12例,FISH异常2/12例。15例使用万珂,5例使用来那度胺,22例使用反应停,6例参加临床试验,2例使用脂质体阿霉素,2例使用砷剂,1例异基因造血干细胞移植。疗效:完全缓解10例,非常好的部分缓解4例,部分缓解8例,疾病稳定1例,疾病进展1例;总有效率91.7%,完全缓解率41.7%。达到完全缓解的时间为2~27个月(中位时间6个月),达到完全缓解后维持的时间为8~48个月(中位时间18个月)。1年总生存率100%,3年预计总生存率95.45%,5年预计总生存率70.67%。结论:MM多见于老年人,但发病年龄有年轻化趋势,年轻患者骨骼损害严重,髓外浸润多见,万珂及来那度胺靶向药物疗效良好,中位生存时间比老年患者长。 Objective: To investigate the clinical manifestations, laboratory features, efficacy and survival of patients with young multiple myeloma (MM) (<50 years old). Methods: The clinical data of 24 patients (<50 years old) with MM were retrospectively analyzed. Results: Young MM patients accounted for 10.1% (24/238) of patients with MM in the same period, with IgG type and light chain type. The DS stage was stage III, ISS stage Ⅰ stage 6 cases, stage Ⅱ stage 14 cases and stage Ⅲ stage 4 cases ; 8 cases of extramedullary infiltration; chromosome karyotype abnormalities (G-band staining) 4/12 cases, 2/12 FISH abnormalities. 15 cases were treated with Velcade, 5 cases were treated with lenalidomide, 22 cases were stopped by reaction, 6 cases were involved in clinical trial, 2 cases were treated with liposomal doxorubicin, 2 cases were treated with arsenic and 1 case was allogeneic hematopoietic stem cell transplantation. Efficacy: complete remission in 10 cases, 4 cases of very good partial response, partial remission in 8 cases, stable disease in 1 case, disease progression in 1 case; the total effective rate was 91.7%, the complete remission rate was 41.7%. The time to complete remission was 2 to 27 months (median 6 months), and the time to complete remission was 8 to 48 months (median 18 months). 1-year overall survival rate of 100%, 3-year estimated total survival rate of 95.45%, 5-year estimated total survival rate of 70.67%. Conclusion: MM is more common in the elderly, but the age of onset is younger. The young patients have severe bone damage and extramedullary infiltration. The Velcade and lenalidomide-targeted drugs have a good effect and the median survival time is longer than that in the elderly.