Copy number analysis of a patient with high-risk MM. (A) A whole chromosome CGH dot plots for chromosome 8 are shown for each sample assayed. Statistically significant CNAs are indicated by light gray shading, which coincides with regions with extensive green dots (deletions) or red dots (amplifications). The 2 regions used to define subclone progenitors 1 and 2, which ebb and flow with time in this patient, are visible as large deletions on the 8p and 8q, respectively. (B) Heat map showing copy number changes in the 5 samples analyzed by Agilent 244k. Sample types are shown on the y-axis and ordered longitudinally. The chromosome location is on the x-axis. Blue shading indicates the presence of copy number loss; red, copy number gain; and white, no copy number abnormality. (C) Dendrogram showing the relation of the observed subclones. Branch length represents the number of CNAs detected by aCGH and assigned to each evolutionary step. There are 5 CNAs shared in all samples and a clear divergence of 2 subclone progenitors defined by 27 or 19 CNAs, respectively. Clones related to subclone progenitor 1 represent the major tumor population at diagnosis and relapse 3 and are differentiated by 2 and 4 CNAs, respectively. Clones related to subclone progenitor 2 represent the majority of the tumor population at relapse 1 and relapse 4/PCL, which are differentiated by 13 and 39 CNAs, respectively.