It was also reported that BMSC-EXs (healthy or MM-derived) both induce upregulation of anti-apoptotic B-cell lymphoma-2 (Bcl-2) and downregulation of pro-apoptotic Caspase 9 and Caspase 3 in MM cells, thereby mitigating BTZ-induced apoptosis (144). This evidence concerns the gene CASP3 and Miyoshi myopathy.