The direct contacts between MM cells and the surrounding stroma stimulate several signaling pathways such as PI3K/Akt, MAPK, Wnt and Notch, and the induction of NF-κB signaling, leading to upregulation of IL-6, VEGF, IGF-1 and GDF15 expression, as well as increased expression of anti-apoptotic proteins [25,31,32,108,128,129]. This evidence concerns the gene VEGFA and Miyoshi myopathy.