The immunosuppressive environment in MM is further shaped by increased levels of regulatory T cells (Tregs), impaired cytotoxic T-cell responses, and dysregulated cytokine signaling [e.g., IL-6, transforming growth factor beta (TGF-β), and stromal cell-derived factor 1 (SDF-1)] [26]. Here, CXCL12 is linked to Miyoshi myopathy.