Within the BM microenvironment, MM cells interact with various components, including BM stromal cells (BMSCs) and ECM proteins such as fibronectin, collagen, osteopontin, hyaluronan, and laminin, which facilitate MM survival, proliferation, migration, and drug resistance through the MEK/MAPK, JAK/STAT, and PI3K/Akt pathways [49,50]. This evidence concerns the gene AKT1 and Miyoshi myopathy.