Although t(4;14) is widely considered a high-risk factor in the management of patients with MM and predicts a poor clinical outcome (38, 39), recent studies also suggested that an enriched gain of 1q+ in high-risk cytogenetic abnormalities leads to inferior outcomes for patients with MM (40), raising the question of whether t(4;14) alone or in combination with other factors, such as the HRP2 levels shown in our findings, determines the true high-risk status of patients with MM. The gene discussed is HDGFL2; the disease is Miyoshi myopathy.