IGF1 and Miyoshi myopathy: The interaction and adhesion of MM PCs with the surrounding BM stroma has been shown to upregulate a number of critical pro-survival and/or anti-apoptotic pathways, including Nuclear Factor kappa-light-chain-enhancer of activated B cells (NF-κB) and Notch signaling pathways, which regulate the expression of key downstream MM supportive factors, VEGF, Insulin-like growth factor-1 (IGF-1), and IL-6 [40].