Fig. 2: cf-mRNA transcriptome reflects dynamical changes of Ig transcripts derived from the BM.

a Matching cf-mRNA and buffy coat samples from a multiple myeloma patient (day −2) were analyzed by RNA-Seq. Fraction of transcripts from the variable regions of the immunoglobulin heavy and light chains identified in plasma and buffy coat samples are shown (center and right panels). Clonally amplified transcripts are indicated in red and dominated the representation of Ig transcripts in cf-mRNA of the MM patient. Levels of Ig transcripts in plasma of a healthy individual (left panel) are shown as reference. b Schematic of the therapeutic treatment performed in MM patients. Melphalan-mediated BM ablation started at day −2, autologous stem cell transplant was performed at day 0. Steroids and G-CSF were then administered as supportive care. Blood was collected every day during the study. c. Bar graphs showing the normalized values (TPM, Y axis) of Ig transcripts detected by RNA-Seq in paired plasma and buffy coat samples throughout the treatment. The repertoire of variable regions of Ig heavy chain and Ig kappa light chain are shown in a color gradient. Dominant transcripts identified in plasma are indicated. Day of blood collection with respect to transplant is indicated in the X axis. d Fraction of transcripts from variable Ig regions in cf-mRNA during BM ablation and transplant. Day of blood collection with respect to transplant is indicated in the X axis. Dominant Ig transcripts, shown in solid blue and red lines, decrease after melphalan-mediated BM ablation.