The International Staging System (ISS), the most widely used prognostic system for MM, stratifies patients into three groups based on serum albumin and β2-microglobulin levels [3], which is well validated and easily applied; however, serum albumin and β2-microglobulin levels may not provide complete prognostic information because they do not incorporate tumor-microenvironment information. The gene discussed is HLA-G; the disease is Miyoshi myopathy.