Using these cut points, multivariable analysis identified the presence of serum M-protein >2 g/dL as an independent prognostic factor predicting high risk of progression to MM (HR: 2.07, 95% CI: 1.62–2.65), together with involved to uninvolved sFLC ratio >20 (HR: 2.66, 95% CI: 2.09–3.38) and BMPC infiltration >20% (HR: 2.39, 95% CI: 1.87–3.05). This evidence concerns the gene MYOM2 and Miyoshi myopathy.