On the other hand, different soluble factors secreted by MM or ancillary cells (myeloid/mesenchymal cells) have been found to modulate and eventually abrogate the antitumor activity of CTLs, including TGF-β, IL-10 as well as the immunosuppressive nucleoside adenosine and ADP (dependent on CD38, CD39, and CD73 enzymatic activity) [25,61]. The gene discussed is CD38; the disease is Miyoshi myopathy.