{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:04:53Z","timestamp":1783573493301,"version":"3.55.0"},"reference-count":110,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T00:00:00Z","timestamp":1629849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005632","name":"Narodowe Centrum Bada\u0144 i Rozwoju","doi-asserted-by":"publisher","award":["ERA\u2010NET TRANSCAN2\/intraMMclo\/2\/2017"],"award-info":[{"award-number":["ERA\u2010NET TRANSCAN2\/intraMMclo\/2\/2017"]}],"id":[{"id":"10.13039\/501100005632","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Plasma cell dyscrasias are a heterogeneous group of diseases characterized by the expansion of bone marrow plasma cells. Malignant transformation of plasma cells depends on the continuity of events resulting in a sequence of well-defined disease stages, from monoclonal gammopathy of undetermined significance (MGUS) through smoldering myeloma (SMM) to symptomatic multiple myeloma (MM). Evolution of a pre-malignant cell into a malignant cell, as well as further tumor progression, dissemination, and relapse, require development of multiple driver lesions conferring selective advantage of the dominant clone and allowing subsequent evolution under selective pressure of microenvironment and treatment. This process of natural selection facilitates tumor plasticity leading to the formation of genetically complex and heterogenous tumors that are notoriously difficult to treat. Better understanding of the mechanisms underlying tumor evolution in MM and identification of lesions driving the evolution from the premalignant clone is therefore a key to development of effective treatment and long-term disease control. Here, we review recent advances in clonal evolution patterns and genomic landscape dynamics of MM, focusing on their clinical implications.<\/jats:p>","DOI":"10.3390\/diagnostics11091534","type":"journal-article","created":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T00:19:26Z","timestamp":1629937166000},"page":"1534","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Clonal Evolution of Multiple Myeloma\u2014Clinical and Diagnostic Implications"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8394-5346","authenticated-orcid":false,"given":"Aleksander","family":"Salomon-Perzy\u0144ski","sequence":"first","affiliation":[{"name":"Department of Hematology, Institute of Hematology and Transfusion Medicine, 14 I. Gandhi St., 02-776 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Jamroziak","sequence":"additional","affiliation":[{"name":"Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 1A Banach St., 02-097 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5865-8425","authenticated-orcid":false,"given":"Eliza","family":"G\u0142odkowska-Mr\u00f3wka","sequence":"additional","affiliation":[{"name":"Department of Hematological and Transfusion Immunology, Institute of Hematology and Transfusion Medicine, 14 I. Gandhi St., 02-776 Warsaw, Poland"},{"name":"Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, 63 Zwirki i Wigury St., 02-097 Warsaw, Poland"},{"name":"Department of Experimental Hematology, Institute of Hematology and Transfusion Medicine, 14 I. Gandhi St., 02-776 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21551","article-title":"Cancer Statistics, 2019","volume":"69","author":"Siegel","year":"2019","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1056\/NEJMoa1516282","article-title":"Oral Ixazomib, Lenalidomide, and Dexamethasone for Multiple Myeloma","volume":"374","author":"Moreau","year":"2016","journal-title":"N. Engl. J. 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