The clinical spectrum of the disease encompasses an asymptomatic stage, such as MGUS with suspected malignant plasma cells producing abnormal monoclonal antibodies (M-protein) in the blood, and a more advanced stage, SMM, characterized by a high proportion of malignant plasma cells in the BM and/or M-protein in the blood.112 Individuals with SMM, although asymptomatic, are genetically mature entity whereby molecularly indistinguishable from those with active MM.113,114 The genetic events in the progression from asymptomatic to MM can be broadly divided into 2 stages. The gene discussed is MYOM2; the disease is Miyoshi myopathy.