TAS of 36 contemporaneously sourced BM and PL samples was performed for RAS-RAF (KRAS, NRAS and BRAF) and DNA-repair genes (TP53, Ataxia telangiectasia mutated (ATM) and Ataxia telangiectasia and Rad3 related (ATR) that are known to be relevant to MM, revealing a predominance of DNA-repair genes alterations in the PL of RR patients. Here, ATR is linked to Miyoshi myopathy.