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为探讨多发性骨髓瘤（Ｍｕｌｔｉｐｌｅｍｙｅｌｏｍａ，ＭＭ）平台期脱逸机制，以克隆性ＩｇＨ基因重排作为骨髓瘤细胞克隆的基因标志，应用聚合酶链反应（ＰＣＲ）基因扩增结合扩增产物直接测序技术分析不同临床期ＭＭ骨髓瘤细胞克隆ＩｇＨ基因重排方式。结果２３例ＭＭ中１８例检测到克隆性ＩｇＨ基因重排，不同患者的重排呈多样性，同一患者不同临床期骨髓瘤细胞具有相同的ＩｇＨ基因重排，３例患者ＰＣＲ扩增产物直接测序证实ＭＭ在病情演变过程中骨髓瘤细胞克隆ＩｇＨ基因未发生突变或碱基置换。结论：ＭＭ平台期脱逸过程中，骨髓瘤细胞克隆本身并没有发生演变
To explore the mechanism of multiple myeloma (MM) plateau escape, clonal IgH gene rearrangement was used as a gene marker for myeloma cell clones, and polymerase chain reaction (PCR) gene amplification was used in combination with amplification product direct sequencing. Technical analysis of different clinical stages of MM myeloma cell clone IgH gene rearrangement. Results The clonal IgH gene rearrangement was detected in 18 cases of 23 cases of MM. The rearrangements of different patients showed diversity. The same patient had same IgH gene rearrangement in different clinical stages of myeloma cells, and 3 cases of PCR products were directly sequenced. It was confirmed that there was no mutation or base substitution in the myeloma cell clone IgH gene during the evolution of MM. Conclusion: The myeloma cell clone itself did not evolve during MM plateau escape.