Gene mutations in pretreatment and relapse MM samples detected by WES. (A) Number of mutations at diagnosis (gray) and acquired mutations in serial relapse time points (red, relapse 1; yellow, relapse 2; green, relapse 3). Each bar shows the total number of mutations at the respective time point (D, diagnosis; R, relapse) in individual patients. Treatments with dexamethasone, immunomodulatory drugs (IMiD), bortezomib and melphalan before the acquisition of the sample are indicated below. (B) Distribution of mutations (number (%)) detected at diagnosis and in relapse samples. Mutations present only at diagnosis are color-coded in blue, mutations present at both time points in gray, and mutations present only at relapse in red. Dashed lines indicate the proportion of mutations with a VAF increase >10% at relapse. (C) Recurrent gene mutations at diagnosis and relapse. Each column represents 1 patient. For each gene, the presence of a mutation (color-coded in red; dark gray indicates no mutations was detected) at different time points is indicated in subsequent rows. On the right-hand side, the frequency of mutated patients at diagnosis and at relapse is given. UPN, unique patient number.