The elevated levels of FVIII and vWF may be a response to increased neoangiogenesis in the bone marrow microenvironment.[21] In a study by Minnema et al,[22] MM patients treated with thalidomide showed extremely high levels of FVIII activity (FVIII:C) and vWF antigen, with average FVIII:C levels at 352% and average vWF antigen levels at 374%. The gene discussed is VWF; the disease is Miyoshi myopathy.