Accumulated evidence has shown that metabolic enzymes such as hexokinase II (HKII) and lactate dehydrogenase A (LDHA) are found in newly diagnosed myeloma patients, and their expression is further upregulated in relapsed MM patients, highlighting that elevated glucose metabolism is important in relapsed compared to newly diagnosed multiple myeloma [13,14]. This evidence concerns the gene LDHA and Miyoshi myopathy.