HCD status correlated with poorer outcomes in the independent validation cohort. (A) PFS and (B) OS according to clonal dominance status (HCD vs others, as assessed by 5′RACE) in the independent validation cohort with available 5′RACE results (n = 37/40). We identified a subset of 6 of 37 patients (16.2%) with the HCD (cutoffs: dominant clonotype representing >81.1% and >78.6% of all CDR3 sequences for IgVH and IgVL, respectively).