The mutational landscape of MM is essentially defined with a relatively small number of genes being recurrently mutated in newly diagnosed MM patients.1,2,3,4 One recent publication that included almost 500 exomes from a homogeneous, untreated cohort,2 identified a number of genes that associated with differential survival in MM patients (CCND1, TP53, ATM, ATR, ZFHX4, NCKAP5, IRF, EGR1). Here, ZFHX4 is linked to Miyoshi myopathy.