CD38 and Miyoshi myopathy: Thus, elotuzumab is considered to have limited therapeutic efficacy in patients with triple-class refractory MM and in patients with anti-CD38 antibody exposure/refractory, making it challenging to achieve significant treatment outcomes. Anti-CD38 antibodies can lead to a decrease in the number of NK cells, and elotuzumab acts by binding to SLAMF7 on myeloma cells, inducing antibody-dependent cellular cytotoxicity (ADCC) through interaction with NK cells via CD16 [2,13].