Table 1.
Patient characteristics at the time of V(D)J sequencing.
Table 2.
Clonality detection overall and in myTYPE positive patients.
Fig 1.
Predicting clonality detection.
A: Dot plot showing the percentage of bone marrow plasma cells in samples by success or failure of clonality detection. Median and quartile range are shown as a superimposed boxplot. B: Similar plot as in A, showing bone marrow plasma cells in samples where myTYPE was positive versus negative. C: Individual sample data and regression curves from a multivariate model to predict clonality detection. The right panel shows lambda light chain restricted multiple myeloma; the left panel shows kappa light chain multiple myeloma, including 1 patient whose tumor cells are negative for both kappa and lambda staining. Within each panel, regression lines shows the probability of clonality detection as a function of bone marrow plasma cell infiltration by aspirate smear within the myTYPE positive (red) and negative (blue) groups. Points plotted along the top panel border represent samples where clonality was detected, whereas no clonal V(D)J sequence could be found in the samples at the bottom. BMPC, plasma cells in bone marrow aspirate smear.
Table 3.
Prediction models for clonality detection.
Fig 2.
More IGK rearrangements and minimal somatic hypermutation of clonal VK-sequences in lambda-restricted multiple myeloma.
A: Clonal fractions of the six most abundant IGK rearrangements in kappa-restricted cases are shown to the left; lambda-restricted to the right. Lines connect rearrangements derived from the same sample. Samples are colored red where the most abundant rearrangement was defined as clonal by the analysis software. Samples where no clonal rearrangement could be identified (teal) are shown to give an impression of the polyclonal background. Lambda-restricted cases show evidence of more clonal sequences compared with kappa-restricted. B: SHM of the most abundant clonal rearrangements involving the VK region in kappa-restricted and lambda-restricted cases, measured as % change from the germline sequence. The red horizontal line at 2% represents the commonly used cut-off between sequences considered non-mutated (below) as compared with significantly mutated (above).
Table 4.
Success rate of clonality assays overall and in subgroups.
Fig 3.
Progressively lower estimates of plasma cell content from core biopsy through aspirate smear and flow cytometry.
A: Dot plot of bone marrow plasma cell infiltration by aspirate smear versus core biopsy, with a fitted linear regression line (solid black) surrounded by its 95% confidence interval (n = 146; slope 0.46; 95% CI 0.37–0.55; R2 = 0.428; p<0.001). B: Similar plot as in A, showing aspirate smear and flow cytometry (n = 114; slope 0.35; 95% CI 0.28–0.42; R2 = 0.483; p<0.001). The diagonal dashed line shows where dots would have aligned if there was a 1:1 relationship between measurements.