IGF1 and Miyoshi myopathy: In this BM microenvironment, MM cells interact closely with hematopoietic and non-hematopoietic cells, (including mesenchymal stromal cells (MSCs), osteoblasts, osteoclasts, and immune cells) through adhesion molecules and the production of different growth factors, such as insulin-like growth factor (IGF), interleukin-6 (IL-6), VEGF, a proliferation-inducing ligand (APRIL), B cell activating factor (BAFF), and stromal cell-derived factor-1α (SDF-1α).