Overall, the data reveal that alterations in the NKG2D pathway are associated with the progression from MGUS to active MM [32], indicate that early changes in both innate and adaptive immunity are in place in MGUS-stage PC tumors (including an increasing number of T CD8+ and group 1 innate lymphoid cells), and indicate that a decrease in stem-like cells may underlie the loss of immune surveillance in MM progression [13]. This evidence concerns the gene CD8A and Miyoshi myopathy.