Age-related immune dysfunction is primarily mediated by immunosenescence which results in ineffective clearance of infective pathogens, poor vaccine responses and increased susceptibility to multi-morbidities. Immunosenescence-related immunometabolic abnormalities are associated with accelerated aging, an inflammatory immune response (inflammaging) and ultimately frailty syndromes. In addition, several conditions can accelerate the development of immunosenescence, including cancer. This is a bi-directional interaction since inflammaging may create a permissive environment for tumour development. Multiple myeloma (MM) is a mature B-cell malignancy that presents in the older population. MM exemplifies the interaction of age- (Host Response Biology; HRB) and disease-related immunological dysfunction, contributing to the development of a frailty syndrome which impairs the therapeutic impact of recent advances in treatment strategies. Understanding the mechanisms by which accelerated immunological aging is induced and the ways in which a tumour such as MM influences this process is key to overcoming therapeutic barriers. A link between cellular mitochondrial dysfunction and the acquisition of an abnormal immune phenotype has recently been described and has widespread physiological consequence beyond the impact on the immune system. Here we outline our current understanding of normal immune aging, describe the mechanism of immunometabolic dysfunction in accelerating this process, and propose the role these processes are playing in the pathogenesis of MM.

与年龄相关的免疫功能障碍主要由免疫衰老介导，导致感染性病原体无法有效清除、疫苗反应不佳以及对多种疾病的易感性增加。免疫衰老相关的免疫代谢异常与加速衰老、炎症免疫反应（炎症）以及最终的衰弱综合征有关。此外，几种情况可以加速免疫衰老的发展，包括癌症。这是一种双向相互作用，因为炎症可能为肿瘤的发展创造一个宽松的环境。多发性骨髓瘤 (MM) 是一种成熟的 B 细胞恶性肿瘤，出现于老年人群中。 MM 体现了年龄（宿主反应生物学；HRB）和疾病相关免疫功能障碍之间的相互作用，导致衰弱综合征的发展，从而削弱了治疗策略最新进展的治疗效果。了解加速免疫衰老的机制以及 MM 等肿瘤影响这一过程的方式是克服治疗障碍的关键。最近描述了细胞线粒体功能障碍与获得异常免疫表型之间的联系，并且除了对免疫系统的影响之外，还具有广泛的生理后果。在这里，我们概述了我们目前对正常免疫衰老的理解，描述了免疫代谢功能障碍加速这一过程的机制，并提出了这些过程在 MM 发病机制中所发挥的作用。