Lenalidomide directly binds to cereblon (CRBN), the component of CRL4CRBN E3 ubiquitin ligase, inducing the ubiquitination and degradation of IKZF1 (Ikaros) and IKZF3 (Aiolos) in MM cells, leading to cytotoxicity and immunomodulatory effects [8,9]. Here, IKZF1 is linked to Miyoshi myopathy.