EVs shed by multiple myeloma cells carry a piwi-interacting RNA (the piRNA-823, that belongs to a class of small non-coding RNAs), which is able to re-educate endothelial cells towards an environment amenable to the growth of multiple myeloma cells, by enhancing VEGF, interleukin 6 (IL-6) and ICAM-1 (intercellular adhesion molecule 1) expression. Here, ICAM1 is linked to AL amyloidosis.