One clinical study provided evidence that the expression frequency of Twist1, which suppresses E-cadherin, in EMD samples from MM patients, is higher than that in BM samples from these patients or MM patients without EMD.5 In another study, the process of EMD formation has been associated with the upregulation of CXCR4 in EMD specimens of patients with MM.6 Notably, our study is the first to examine the E-cadherin expression of MM cells using BM biopsy specimens from patients. This evidence concerns the gene TWIST1 and Miyoshi myopathy.