It is likely that a cascade of events in the TME occur following failure of CAR-T cells to kill resistant MM cells, resulting in overactivation of CAR-T cells, which then induces an increase in immune checkpoint receptors such as PD-1, LAG-3, TIM3, and TIGIT, which can then be exploited by MM cells. This evidence concerns the gene HAVCR2 and Miyoshi myopathy.