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NAD + plays a crucial role in a broad network of metabolic enzymes, such as nicotinamide phosphoribosyltransferase (NAMPT), nicotinate phosphorybosiltransferase (NAPRT), Sirtuins, and Sterile α-Toll/interleukin receptor (TIR), as well as the recently identified TIR motif- containing 1 (SARM1) ( CD38 is overexpressed by malignant plasma cells, significantly affecting i) the enzymatic reactions of CD38 within the BM niche, ii) the types of CD38-associated ectonucleotidases ( e.g

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Reduced ADA/CD26 expression impairs ADO clearance and correlates with resistance, whereas ADA overexpression in advanced MM suggests context-dependent regulation (87–89)