Sequential mutations in exponentially growing populations

Stochastic models of sequential mutation acquisition are widely used to quantify cancer and bacterial evolution. Across manifold scenarios, recurrent research questions are: how many cells are there with n alterations, and how long will it take for these cells to appear. For exponentially growing populations, these questions have been tackled only in special cases so far. Here, within a multitype branching process framework, we consider a general mutational path where mutations may be advantageous, neutral or deleterious. In the biologically relevant limiting regimes of large times and small mutation rates, we derive probability distributions for the number, and arrival time, of cells with n mutations. Surprisingly, the two quantities respectively follow Mittag-Leffler and logistic distributions regardless of n or the mutations' selective effects. Our results provide a rapid method to assess how altering the fundamental division, death, and mutation rates impacts the arrival time, and number, of mutant cells. We highlight consequences for mutation rate inference in fluctuation assays. Author summaryIn settings such as bacterial infections and cancer, cellular populations grow exponentially. DNA mutations acquired during this growth can have profound effects, e.g. conferring drug resistance or faster tumour growth. In mathematical models of this fundamental process, considerable effort-spanning many decades-has been invested to understand the factors that control two key aspects of this process: how many cells exist with a set of mutations, and how long does it take for these cells to appear. In this paper, we consider these two aspects in a general mathematical framework. Surprisingly, for both quantities, we find universal probability distributions which are valid regardless of how many mutations we focus on, and what effect these mutations might have on the cells. The distributions are elegant and easy to work with, providing a computationally efficient alternative to intensive simulation-based approaches. We demonstrate the usefulness of our mathematical results by illustrating their consequences for bacterial experiments and cancer evolution.