MM cell survival, disease progression, and drug resistance are associated with alterations in MSC, including augmented gene expression of angiogenic and growth factors (such as CD40/40L, VCAM-1, ICAM-1, LFA-3 (lymphocyte function-associated antigen-3), and HO-1 (heme oxygenase 1), and immunomodulation of cytokines (increased IL-6 and reduced IL-10) [65, 66, 69]. The gene discussed is HMOX1; the disease is Miyoshi myopathy.