Relapse after Allogeneic Hematopoietic Cell Transplantation for Myelodysplastic Syndromes: Analysis of Late Relapse Using Comparative Karyotype and Chromosome Genome Array Testing  Cecilia C.S. Yeung, Aaron T. Gerds, Min Fang, Bart L. Scott, Mary E.D. Flowers, Ted Gooley, H. Joachim Deeg  Biology of Blood and Marrow Transplantation  Volume 21, Issue 9, Pages 1565-1575 (September 2015) DOI: 10.1016/j.bbmt.2015.04.024 Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 1 Cumulative incidence of relapse (A) and hazard of relapse over time (B). Biology of Blood and Marrow Transplantation 2015 21, 1565-1575DOI: (10.1016/j.bbmt.2015.04.024) Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 2 (A) Bone marrow karyotypes before HCT (broken pie chart) and at the time of relapse (intact pie charts) in 213 patients with early relapse. (B) Bone marrow karyotypes before HCT (broken pie chart) and at the time of relapse (intact pie charts) in 41 patients with late relapse. Biology of Blood and Marrow Transplantation 2015 21, 1565-1575DOI: (10.1016/j.bbmt.2015.04.024) Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 3 Probability of survival in patients after early and late relapse. Biology of Blood and Marrow Transplantation 2015 21, 1565-1575DOI: (10.1016/j.bbmt.2015.04.024) Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 4 Comparative CGAT in patient number 1. The top blue bar represents the pre-HCT CGAT copy number aberration data. The expanded excerpt from the top bar shows del 20q in the pre-HCT sample. The bottom blue bar represents the post-HCT relapse CGAT copy number aberration data, showing a new monosomy 7 with persistence of the del 20q. This Figure is available in color online at www.bbmt.org. Biology of Blood and Marrow Transplantation 2015 21, 1565-1575DOI: (10.1016/j.bbmt.2015.04.024) Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 5 (A) Comparative CGAT in patient number 2. The top blue bar represents the pre-HCT CGAT copy number aberration data, which show a normal female genome. The bottom blue bar represents the post-HCT relapse CGAT copy number aberration data, showing new chromosomal aberrations with deletions of chromosomes 2q and 6q (red arrow), as well as a gain/deletion in 9q (green arrow). (B) Diagram outlining the complex clinical history of patient 2 from her initial diagnosis of AML to her death. (C) The green dotted lines are the SNP allele tracks; in a healthy heterozygous person there would be 3 lines, however, in the relapse sample from patient 2 there are 5 lines, which are nearly equally distributed, representing a chimeric ratio of 40% to 60%. The 4-line tracks on the right represent a segmental deletion of chromosome 2. This Figure is available in color online at www.bbmt.org. Biology of Blood and Marrow Transplantation 2015 21, 1565-1575DOI: (10.1016/j.bbmt.2015.04.024) Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 6 (A) Comparative CGAT in patient number 3. The top blue bar represents the pre-HCT CGAT copy number aberration data, which show a normal male genome. The bottom blue bar represents the post-HCT relapse CGAT copy number aberration data, showing new chromosomal aberrations with a partial deletion of chromosome 15q (red arrow). (B) Detailed view of chromosome 15, with the red bar depicting the segmental deletion seen in the post-HCT CGAT data (pink, bottom lines) in comparison with the pre-HCT CGAT data (blue, top lines). This Figure is available in color online at www.bbmt.org. Biology of Blood and Marrow Transplantation 2015 21, 1565-1575DOI: (10.1016/j.bbmt.2015.04.024) Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions