Andersen et al evaluated the relationships of four HPSE SNPs with multiple myeloma patients and found that the rs4693608 genotype A/A increased the susceptibility to vertebral fractures significantly, which may be result from the higher HPSE mRNA expression in carriers of the rs4639608 A/A that stimulates osteoclastogenesis and osteoclast activity through RANKL activation and inhibiting osteoblastogenesis (Andersen et al., 2015). Here, HPSE is linked to plasma cell myeloma.