Preleukemic clonal dynamics. Representation of (preleukemic) clonal evolution occurring in patients UPN13 (A), UPN18 (B), and UPN01 (C). The upper panel shows percentages of clones detected at different sampling moments. The x-axis represents the time before and after ASCT (years). Dashed lines represent sampling moments; black lines for DNA derived from PBSC, BM-MNC, or PB-MNC samples; and white for DNA derived from BM slide or BM sediment material. Known leukemic driver genes are indicated in corresponding clones. Diagnosis details and treatment are indicated above the figure panels. Values for hemoglobin and MCV are depicted in the bottom section of each panel. For other PB values, see supplemental Figure 5. Periods of treatment are indicated with light blue planes. For UPN18 (B), the time after PBSC apheresis is plotted because this patient did not undergo ASCT. CAD, cyclophosphamide, Adriamycin, and dexamethasone; CHOP, cyclophosphamide, doxorubicin, vincristine, and prednisone; CP, cyclophosphamide; CVD, cyclophosphamide, bortezomib, and dexamethasone; Dexa, dexamethasone; DHAP-VIM-DHAP, dexamethasone, cytarabine, cisplatin, etoposide, ifosfamide, and methotrexate; EPO, erythropoietin; G-CSF, granulocyte colony-stimulating factor; HDM, high-dose melphalan; IDM, intermediate-dose melphalan; LEN, lenalidomide; Melph, melphalan; VAD, vincristine, Adriamycin, and dexamethasone.