Glycosylation of immunoglobulins differs between myeloma patients with and without BD. (A) Heat map presenting glycosylation traits in the 3 groups: healthy control subjects (n = 51), no BD (n = 33), and BD (n = 43). TC, total complex; F, fucosylation; B, bisection; G, galactosylation; S, sialylation; S0, nonsialylated; F0, nonfucosylated; G0, nongalactosylated; A2, Diantennary glycans. The last letter indicates the subject of the calculation (eg, fucosylation [F]), and the preceding letters indicate the group on which it is calculated. Sialylation (B) and galactosylation (C) of immunoglobulins in healthy control subjects (n = 51), myeloma patients without BD (n = 33), and patients with BD (n = 43). *P < .05, **P < .01 using the Kruskal-Wallis test, then Dunnett’s multiple comparisons. Sialylation (D) and galactosylation (E) of individual patients before and after the onset of BD (n = 8). *P < .05 using Wilcoxon matched-pairs signed rank test. (F) Serum CTX-1 levels in patients with low (n = 17, lower 20th percentile) or high (upper 20th percentile) IgG galactosylation. (G) Volcano plot comparing glycosyltransferase expression in myeloma cells in patients without (n = 36) and with (n = 137) BD. Unadjusted P values are shown on the y-axis. Error bars represent mean ± standard error of the mean. *P < .05, **P < .01 using the Mann-Whitney U test.