Clonotypic expansions and disease course. Changes in the size of LGL clone were recorded prior to and after oral cytoxan therapy resulting in remission in 6 patients. (A) Clonotype expansions within CD8 cell population (percent of VB family within CD8⁺ population multiplied by % of identical sequences within a VB family). (B) Comparisons of redundancy (defined as percent of the pathogenic clone within VB family) before (▦) and after (▨) therapy and diversity (defined as percent of different clones within all clones sequenced). (C-D) Examples of the changes of clonal size expressed as percent of the total CD8 spectrum during the course of disease in 2 patients with LGL leukemia associated with pure red cell aplasia (▦). Lines represent the hemoglobin levels (+) and absolute reticulocyte counts (×). Tx and arrows indicate transfusions; Hg, hemoglobin; and Ret, reticulocytes. Error bars represent 2 SD.