Analysis of Vβ expansions over time reveals a heterogeneous clonal course in the study population. (A) Representative patient with borderline oligoclonal expansions at the initial observation (left pie representation black bars) that, by the most recent time point, had changed to monoclonal (right pie white bars). (B) Patient with biclonal expansion shown at baseline, then CD8⁺ T cells expressing Vβ3 decreased, whereas Vβ7.1 became dominant. (C) Patient shown with an initial extreme monoclonal expansion that became biclonal. (D) Patient with unchanging monoclonal expansion. Gray bars represent the mean of the control population and error bars are the mean + 3 SD. Similar results were obtained using absolute counts. All patients shown in this figure were followed for roughly 2 years. (E) Of the 143 patients in our cohort, 71 were available for long term Vβ follow-up beyond 6 months. Twenty-six of 71 patients demonstrated clone switching as detected by flow cytometry; graphs of 8 representative patients are depicted here. The interval between time points varied from 6 months to 1 year.