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Although these cell subsets are recruited to the tumor site to fine-tune immune activation, they have the perverse effect of boosting tumor growth ( Therapeutic Strategies to Counteract Adenosine Suppressive Mechanisms in MM Immune Checkpoint Molecules in MM Bone Marrow Preclinical and clinical studies revealed that most tumors overexpress immune checkpoint (ICP) molecules, of which the most studied are programmed death-1 (PD-1) and its ligand (PD-L1) and cytotoxic T-lymphocyte-associated protein-4 (CTLA-4) (82, 83)