Several of the most downregulated genes (for example, ST3GAL6, CT45, LPXN, RHOU) have been implicated with cellular adhesion and motility, whereas many upregulated genes are associated with activation of PI3K/AKT/mTOR signaling (for example, LGALS1, EIF4E2, MAPKAP1, SEMA4D) and cell proliferation (for example, BCL11A, RAB31).37, 38, 39 In BTK-KD INA6 cells, increased protein expression and phosphorylation of mTOR suggests that the loss of BTK and subsequent adhesion to stroma may increase proliferative potential of MM cells. Here, SEMA4D is linked to Miyoshi myopathy.