Figure 1.

Patient with two multiple myeloma (MM) subpopulations correlating separately to monoclonal protein and free light chain detection through the course of disease. A, UMAP clustering analysis of bone marrow biopsy samples from patient #1093 at all three timepoints showed two distinct subpopulations of MM cells (LCE-MM and IGH-MM), along with the expected normal bone marrow cell types. B, Both MM subpopulations displayed transcript expression for the prototypical MM markers including high CD138, CD38, and light chain restricted to kappa only, but only IGH-MM expressed IGH. C, Clinical measurements of serum monoclonal (M) protein and free kappa light chain for patient #1093 from diagnosis through their disease course up to the date of transition to comfort care. D, UMAPs of scRNA-seq data from each timepoint individually, showing the two MM cluster (LCE-MM and IGH-MM) relative contributions from each sample. E, LCE-MM and IGH-MM were present at diagnosis, and only LCE-MM was present at first relapse. ASCT, autologous stem cell transplant; Benda, bendamustine; DCEP, dexamethasone, cyclophosphamide, etoposide, and cisplatin; DPD, daratumumab, pomalidomide, and dexamethasone; Elo, elotuzumab; FKLC, free kappa light chain; HTB, Hematology Tissue Bank; K, carfilzomib; KPD, carfilzomib, pomalidomide, and dexamethasone; MKs, megakaryocytes; Monos, monocytes; NK, natural killer; Progen, progenitors; RBCs, red blood cells; Rel, relapse; RVD, revlimid, velcade, and dexamethasone.