Differences in induction regimens used to treat MM across the world may account for the differences seen in the survival benefit afforded by tandem auto-HCT, but with the unprecedented responses rates seen with the advent of quadruplet induction regimens containing VRD plus an anti-CD38 monoclonal antibody and the use of cellular and immunotherapies such as CAR-T and bispecific antibodies in earlier lines of therapy on the horizon, the role of tandem auto-HCT appears to be fading away. This evidence concerns the gene CD38 and Miyoshi myopathy.