IGF-1 and insulin at 0.01-10 ng/ml potently stimulated the survival in 2 of 4 MM cell lines in Syn-H serum free medium (IGF-1 10 ng/ml: 2.1 ± 0.2 and 10.0 ± 2.7 fold viable cells compared to control in KMS-12-BM and MM.1S, respectively; insulin 10 ng/ml: 1.3 ± 0.02 and 8.6 ± 2.0), which was not abrogated by combined treatment with 10 μg/ml rhIGFBP7 (Figure 4F). Here, INS is linked to Miyoshi myopathy.