Taken together, this paired analysis of BM and peripheral CD8+ T cells indicates reduced CD8+ T-cell proliferative and effector function within the BM environment in MM, alongside increased BNIP3 abundance in activated cells, and decreased levels of the mTOR activator Rheb and target c-Myc, thereby reflecting mechanistic features of T-cell suppression induced by hypoxic exposure. The gene discussed is RHEB; the disease is Miyoshi myopathy.