Nonetheless, the finding that EIF4E3 expression is increased in certain chemoresistant minimal residual disease and relapsed MM patient samples and is predictive of Nrf2 target gene activation, strongly suggests that the Nrf2-EIF4E3 axis and eIF4E3-driven translation contributes to MM drug resistance mechanisms in the clinical setting. This evidence concerns the gene EIF4E3 and Miyoshi myopathy.