VQ MM mice fully recapitulate the biological and clinical features of human high-risk MM, including hyperproliferation, hyperactivation of MEK/ERK and AKT pathways downstream of RAS, extramedullary MM dissemination, upregulation of PD-1 and TIGIT immune checkpoint pathways, exhaustion of CD4+ and CD8+ T cells, and expression of the human UAMS-70 high-risk gene signature3. This evidence concerns the gene CD4 and Miyoshi myopathy.