Clone size distributions among ACs. Clones are displayed in descending order based on size. Three main patterns were observed across the samples: polyclonal, oligoclonal, and monoclonal. (A) Left-most section of the graph: ACs whose clinical status did not progress. None of the samples with polyclonal patterns showed progression over time. Right-most section of the graph: ACs whose clinical status progressed. All ACs with atypical oligoclonal or monoclonal patterns showed progression. (B) Comparison of clone sizes between ACs with and without progression. Group A, ACs without progression; Group B, ACs with progression. Clone sizes of the first top clones among ACs who remained ACs vs those who developed ATL. The intergroup difference regarding the size of the first top clone was significant (Student t test, P = .0001).