Multiple myeloma (MM) is a haematological malignancy characterised by the proliferation and accumulation of terminally differentiated abnormal plasma cells in the bone marrow. Patients suffer from bone pain, factures, anaemia, osteolytic lesions and renal failure. Despite recent advancement in therapy MM remains an incurable disease due to the emergences of drug resistance and frequent relapse. For many decades, research has been heavily focused on understanding the relationship between bone cells such as osteoblast, osteocytes and osteoclasts and the infiltrating tumour cells. However, it is now clear that the tumour-supportive bone microenvironment including cellular and non-cellular components play an important role in driving MM progression and bone disease. One of the most abundant cell types in the bone microenvironment is the bone marrow adipocyte (BMAd). Once thought of as inert space filling cells, they have now been recognised as having specialised functions, signalling in an autocrine, paracrine and endocrine manner to support normal systemic homeostasis. BMAds are both an energy store and a source of secreted adipokines and bioactive substances, MM cells are able to hijack this metabolic machinery to fuel migration, growth and survival. With global obesity on the rise, it has never been more important to further understand the contribution these cells have in both normal and disease settings. The aim of this review is to summarise the large body of emerging evidence supporting the interplay between BMAds and MM cells and to delineate how they fit into the vicious cycle of disease.

多发性骨髓瘤 (MM) 是一种血液系统恶性肿瘤，其特征是骨髓中终末分化的异常浆细胞增殖和积聚。患者患有骨痛、骨折、贫血、溶骨性病变和肾功能衰竭。尽管最近在治疗方面取得了进展，但由于出现耐药性和频繁复发，MM 仍然是一种无法治愈的疾病。几十年来，研究一直集中在了解骨细胞（如成骨细胞、骨细胞和破骨细胞）与浸润性肿瘤细胞之间的关系上。然而，现在很清楚，包括细胞和非细胞成分在内的支持肿瘤的骨微环境在推动 MM 进展和骨病方面起着重要作用。骨微环境中最丰富的细胞类型之一是骨髓脂肪细胞 (BMAd)。曾经被认为是惰性空间填充细胞，它们现在被认为具有特殊的功能，以自分泌、旁分泌和内分泌方式发出信号以支持正常的全身稳态。BMAds 既是能量储存器，也是分泌脂肪因子和生物活性物质的来源，MM 细胞能够劫持这种代谢机制来促进迁移、生长和存活。随着全球肥胖症的增加，进一步了解这些细胞在正常和疾病环境中的作用变得前所未有的重要。本综述的目的是总结大量新出现的证据，支持 BMAds 和 MM 细胞之间的相互作用，并描述它们如何适应疾病的恶性循环。