TNF and Miyoshi myopathy: Further investigations have shown that besides their direct effect on MM plasma cells (PCs) thalidomide and lenalidomide, they abrogate the adhesion of MM cells to the bone marrow stromal cells and block the secretion of growth factors, survival factors, angiogenic cytokines (interleukin (IL)-6, tumor necrosis factor (TNF)-alpha, vascular endothelial growth factor (VEGF), and fibroblast growth factor (FGF)-2) triggered by the cross talk between tumor cells and their microenvironment [11, 12].