This synergy between ES and BTZ was similarly observed in patient-derived MM cells ex vivo cultured in the presence of patient-derived stromal elements to recapitulate essential elements of the bone marrow microenvironment; in comparison, panobinostat-BTZ synergy was detected less consistently (Figure 6, D and E; and Supplemental Figure 6) (39). This evidence concerns the gene CASC3 and Miyoshi myopathy.