Mostly upregulated B cell signaling regulators (such as MMSET, MYD88, c-Myc, CXCR4, and Notch-1), stem cell marker KLF-4, ABC transporter CD243, and PC aberrant markers (CD47 and CD52) were noted from immature to naive B cells in all MM stages with upregulation of sXBP-1 (T1) and CD200 (T3 and N) only in MGUS or SMM (Figure 3C), showing signaling perturbations in both premalignant and active MM stages. This evidence concerns the gene KLF4 and Miyoshi myopathy.