It is well known that t(14;16) is associated with a high-risk and is likely responsible for innate resistance to proteasome inhibitors.[24] In addition, other factors, including ISS III, elevated LDH, negative CD56, and thrombocytopenia, are associated with shorter PFS and OS in t(14;16)-positive patients.[24–26] As recently observed, t(14;16)-positive MM is associated with unfavorable outcomes, even in the era of novel drugs[24,27]. Here, NCAM1 is linked to Miyoshi myopathy.