The first data on how changes in M-protein impact on progression came from the recognition of an evolving subtype among SMM patients treated at a single institution in Spain.17 Rosinol et al.17 found that TTP to MM was significantly higher among patients in whom serum M-protein increased in each of the first two consecutive follow-up visits after SMM diagnosis compared with patients who did not experience such a change; moreover, this evolving subtype was the only factor that independently predicted for shorter TTP. The gene discussed is MYOM2; the disease is Miyoshi myopathy.