FIGURE 2.

Model for the pathogenesis and evolutionary trajectory of multiple myeloma. MGUS, monoclonal gammopathy of undetermined significance; SM smoldering myeloma; MM, multiple myeloma. The fish plot demonstrates a model for the evolutionary trajectory of myeloma. The vertical dashed lines represent punctuated evolution which is characterized by the emergence of subclones that may become dominant. Static evolution occurs in‐between and represents the expansion of existing subclones under positive selection [Color figure can be viewed at wileyonlinelibrary.com]