The iFISH technique used in this study has been previously described. Bone marrow (BM) aspirate samples anticoagulated with EDTA were collected, and CD138+ plasma cells (PC) were isolated using CD138+ magnetic beads (Miltenyi Biotec, Paris, France). iFISH analysis for CA included del(13q), del(17p), gain/amp(1q), t(11;14)(q13;q32), t(4;14)(p16.3;q32), and t(14;16)(q32;q23) in 200 interphase nuclei. The cut-off values for del(17p), gain/amp(1q), del(13q), and translocations were previously reported to be 50%, 20%, 10%, and 10%, respectively.13 (link) Patients with del(17p), t(4;14), or t(14;16) were categorized as having high-risk CA,10 (link) whereas those without these CA were considered standard-risk.