Factors associated with poor response in MM include uncontrolled disease, immunosuppression, concomitant therapy, more lines of therapy, CD38 antibody-directed and B-cell maturation antigen (BCMA)-directed therapy [1,4,5,7]; WM treatment with anti-CD20-based therapies predisposes to poor response to vaccination [6,8]. This evidence concerns the gene CD38 and Miyoshi myopathy.