Workflow for detecting pregain and postgain deletions in patients with MM. Cartoons summarizing a (A) pregain deletion event, (B) postgain deletion event, and (C) pregain deletion and postgain deletion events involving a loss-of-heterozygosity. Numbers (ie, 3:1) indicate the number of total alleles to the number of minor alleles. (D) Example of a copy-number plot of a HY/IgH-neg patient with newly diagnosed MM. (E) Molecular time output for the patient’s large chromosomal gains. (F) Copy number plot zoomed in on pregain deletion involving the TSG TCF3. (G) Example of postgain deletion near the oncogene PIK3CA. In panels F-G, the horizontal black and orange lines represent the total copy number and the minor allele, respectively. The vertical line represents SV deletions. (H) Workflow for identifying early pregain (yellow) and postgain (green) deletion events mediated by SV in study cohorts.