Correlates of immune aging. (A) Chronologic age (ChrAge) and AAIS in patients with MGUS (n = 36) and NDMM (MM_1; n = 41). (B) ChrAge and AAIS in Black (n = 16) and White patients with MGUS (n = 18). (C) Transcriptional profiles related to immunologic aging in MM and MGUS. Data shown are top enriched pathways based on pathway analysis (hallmark, _H; reactome, _R) of differentially expressed genes from immune-old (n = 5) vs immune-young patients with MM (n = 4) and immune-old (n = 7) and immune-young patients with MGUS (n = 7) (split by median AAIS) in CD4 T cells, CD8 T cells, myeloid cells, and tumor cells. Pathways in pink are enriched in immune-aged and those in blue are enriched in immune-young. Detection of baseline levels of phosphoproteins (pSTAT1, pSTAT3, pSTAT5, p38, and pERK) by mass cytometry in circulating CD3⁺ T cells (D), CD14⁺16^– monocytes (E), and CD14⁺16⁺ monocytes (F) in healthy controls (n = 10) and MM (n = 6). (G) ChrAge and AAIS in patients with MM who developed receptor-binding domain (RBD^–) binding antibodies after severe acute respiratory syndrome coronavirus 2 vaccination (RBD⁺; n = 69) vs those who did not (RBD^–; n = 14). Each dot is a unique patient. P values were calculated using a 2-tailed Mann-Whitney. Bar graphs represent mean ± SEM. P values were calculated using a 2-tailed Mann-Whitney. EMT, epithelial-mesenchymal transition; G2M, G2/mitosis; H, hallmark; MMI, median metal intensity; ns, not significant; R, reactome; TCR sig, T cell receptor signature.