Prognostic impact of gain(1q) in the context of and in combination with other risk markers in multiple myeloma. (A, B) Kaplan-Meier overlay plots demonstrate the impact of including gain(1q) as a risk marker in the Revised International Staging System (R-ISS), termed R-ISS-1q. Plots show overall survival for R-ISS and for R-ISS-1q for the GMMG trials (A) and the Myeloma XI trial (B). (C, D) Kaplan-Meier plots are shown for overall survival of patients in the GMMG trials (C) and Myeloma XI trial (D) according to the number of risk markers present in these patients, including gain(1q) and R-ISS markers del(17p), t(4;14), t(14;16) or lactate dehydrogenase above the upper limit of normal. (E, F) Kaplan-Meier plots for overall survival showing discrimination of high- and ultra-highrisk groups by including information on co-occurrence of risk markers, called multi-hits (MH), for further subgrouping of R-ISS-1q stage II and stage III tumors in GMMG trials (E) and the Myeloma XI trial (F). The corresponding progression-free survival plots are presented in the Online Supplementary Data.