Early mortality in the patients with multiple myeloma who were treated upfront with a novel agent-containing regimen

e112 clonal aberrations by conventional cytogenetic analysis. Depending on the cIg-FISH probe, negative or positive conversion was present in 6.5% to 35.3% of the patients. Most patients (75.0%) showed clonal change during disease progression. Cytogenetic abnormalities of chromosome 1 and 13 and del(6)(q25) were the most frequently identified numerical or structural changes. Conclusion: Clonal changes were frequently detected by karyotyping or cIg-FISH with progression of MM. Clonal gains or losses were present in individual patients supporting the coexistence of the sequential clonal evolution and the clonal tide model for pathogenesis of MM. Complex process occurs in the progression of disease, requiring thorough evaluation of karyotypes and cIg-FISH for study of MM oncogenesis.