MM cells-microenvironment interaction and secretion of proinflammatory cytokines (such as IL-6) promote PD-L1 upregulation on MM cell surface, which both inhibits T cell-mediated anti-MM immunity (94) and promotes MM cell survival by inducing reverse signaling to MM cells and activating the PI3K/AKT pathway (94). Here, AKT1 is linked to Miyoshi myopathy.