CD40LG and Miyoshi myopathy: Recently updated analysis of the large southeastern Minnesota cohort [5] concerning 1384 patients with MGUS with a median follow-up of 34 years showed among patients with non-IgM MGUS that the presence of two adverse risk factors—namely, an abnormal serum free light chain ratio (ratio of kappa to lambda free light chains) and a high serum monoclonal protein (M protein) level (≥1.5 g per deciliter)—was associated with a risk of progression to active MM at 20 years of 30%, as compared with 20% among those who had only one risk factor and 7% among those who had neither risk factor.