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B-cell Immunoglobulin Kappa Light Chain Gene Rearrangement

Test Code

M IGK

Test Synonyms

B-cell gene rearrangement, B-cell clonality

Associations

B-cell  Lymphoma; Differentiation of malignant from reactive lymphoid proliferations

Methodology

Polymerase chain reaction (PCR), Capillary gel electrophoresis

Turnaround Time

3-5 days

Specimen Requirements

5.0 mL (min. 3.0 mL) whole blood EDTA or Sodium Heparin
3.0 mL (min. 1.0 mL) bone marrow EDTA or Sodium Heparin
5 mm^3 bone marrow core biopsy, fresh tissue or frozen tissue in MPLN RPMI
3.0 mL (min. 2.0 mL) FNA in MPLN RPMI medium
Formalin fixed paraffin embedded tissue

Specimen Stability
EDTA whole blood or bone marrow stable at 18-25°C for 72 hours
Bone marrow biopsy, fresh tissue or FNA in MPLN RPMI at 2-8°C stable for 72 hours
Frozen tissue at 20°C stable indefinitely
Paraffin embedded tissue at 18-25°C stable indefinitely
Storage & Handling

EDTA whole blood, bone marrow, bone marrow biopsy, fresh tissue or FNA, ship in a Styrofoam container with a cool/refrigerated pack (Do not allow the cool pack to directly contact the sample.)
Frozen tissue, ship on dry ice
Paraffin embedded tissue, ship ambient

Causes for Rejection

Insufficient volume; Specimen at incorrect temperature; Incorrect anticoagulant or fixative

Reference Range

No rearrangement detected (germline)

Description

Evaluation for suspected clonal B-cell lymphoproliferations when morphologic, immunochemical, and/or flow cytometry analyses are inconclusive. Molecular IgK testing is a useful complement to IgH analysis for confirmation of clonality in post-germinal center (mature) B-cell neoplasms where clonotypic IgH signatures may not be detected due to somatic hypermutation of VH genes.

References
  1. Van Krieken JHJM et al. (2007).  Improved reliability of lymphoma diagnosis via PCR-based clonality testing:—Report of the BIOMED-2 Concerted Action BHMA-CT98-3936.  Leukemia. 21:201-206.
  2. Evans P et al. (2007). Significantly improved PCR-based clonality testing in B-cell malignancies by use of multiple immunoglobulin targets: Report of the BIOMED-2 Concerted Action BHMA-CT98-3936. Leukemia. 21:207-214.
  3. Liu H et al. (2007).  A practical strategy for the routine use of BIOMED-2 PCR assays for detection of B- and T-cell clonality in diagnostic haematopathology. Br J Haematol. 138:31-43.
  4. Pai RK et al. (2005). B-cell clonality determination using an immunoglobulin κ light chain polymerase chain reaction method. J Molec Diagn. 7:300-307.
  5. Van Dongen JJM et al. (2003). Design and standardization of PCR primers and protocols for detection and clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations:  Report of the BIOMED-2 Concerned Action BMH4-CT98-3936. Leukemia. 17:2257-2317.