MM-associated T-cells could present a mixed phenotype, which ranges from a “senescent” effector phenotype, characterized by positivity to KLRG-1, CD57, CD160 associated to low or negative CD28, CTLA4, and PD1, up to an “exhaustion” phenotype, which includes the positivity for PD1, CTLA-4, CD57 and the lack of CD28 [22,25,43,60]. This evidence concerns the gene CTLA4 and Miyoshi myopathy.