We have demonstrated elevated levels of MPs and immune cells in MM patients compared to healthy controls, also the levels of these cells and particles were lower in patients achieved CR compared to those without CR, Microparticles and PD1 expressions were associated with proliferative potential and resistance to Bortezomib-based treatments, our results suggested that they played a crucial role in myeloma progression, in addition this study provides support for the potential prognostic value of MPs and the possible interplay between MPs and PD1 in multiple myeloma. Here, RPL17 is linked to Miyoshi myopathy.