Mainline Stemline Sideline and Clonal Evolution

These terms can be confusing and are often misunderstood. The mainline (ml) is the term used to describe the most common clone (i.e., the one represented by the most cells). This is a quantitative issue only. It does not necessarily indicate the most basic clone in tumor progression, which is referred to as the stemline (sl). Clones that evolve from the stemline are referred to as sidelines (sdl):

46,XY,t(9;22)(q34;q11.2)q34;q11.2)[5]/47,XY,+8,t(9;22)(q34;q11.2)[11]/46,XY,t(9;22)(q34;q11.2),i(17)(q10)[4]

When more than one clone is present but no clear clonal progression is evident, the mainline is listed first, followed by each clone in order of relative size. When clonal evolution is present, the stemline is listed first, with sidelines listed in order of increasing complexity whenever possible, or by clone size when more than one sideline evolves independently from the stemline, as in the preceding example.

Composite Karyotype (cp)

When a clone contains multiple abnormalities, a frequent occurrence is that not all changes are present in every cell, yet the interpretation can be made that these cells do, in fact, represent a single abnormal clone rather than an evolving process. To report such a phenomenon, the clone is described as a composite, using the abbreviation "cp" before the number in brackets. It should be noted that this can occasionally produce seemingly contradictory data, as some cells will contain additional copies of a chromosome that is missing in others.

Clones o stemline mainline sidelines

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