The contribution of the hypoxic BM environment in acquiring 1q21 copy number gain in myeloma is not known, but 1q21+ and hypoxic BM environment together can contribute to ADO production through both HIF‐1‐mediated CD73 upregulation,67, 69 and through the CD38/CD203a/TRACP pathway, and thus contribute to NK‐cell dysfunction in MM.32, 50, 65. This evidence concerns the gene HIF1A and Miyoshi myopathy.