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T-Cell TCR Gene Rearrangement by NGS

Test Code

M TCR

Test Synonyms

T-cell receptor gamma (TCRγ) gene rearrangement, T cell gene rearrangement

Methodology

Next Generation Sequencing (NGS)

Turnaround Time

5-7 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
Whole blood or bone marrow stable at 18-25°C for 72 hours
Bone marrow biopsy, fresh tissue or FNA in MPLN RPMI stable at 2-8°C for 72 hours
Frozen tissue stable at -20°C indefinitely
Paraffin embedded tissue stable at 18-25°C indefinitely
Storage & Handling

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

Improper specimen labeling; Insufficient sample volume; Clotted specimen; Specimen older than 7 days

Reference Range

No rearrangement detected (germline)

Description

Molecular characterization of T-cell receptor gene rearrangements and immunoglobulin heavy and light chain gene rearrangement detection is accomplished with reliable and robust tests to identify clonal T-cell and B-cell populations in a variety of cutaneous lymphoproliferative disorders.

While the demonstration of a clonal T/B cell population is not necessarily reflective of a truly pathologic process, positive results interpreted in the context of all laboratory findings can support diagnosis of malignancy. The ability to routinely perform these studies make these highly sensitive and specific tests well suited for the evaluation of these conditions.

References
  1. Gazzola, A., Mannu, C., Rossi, M., Laginestra, M. A., Sapienza, M. R., Fuligni, F., . . . Pileri, S. (2014). The evolution of clonality testing in the diagnosis and monitoring of hematological malignancies. Therapeutic Advances in Hematology, 5(2), 35-47. doi:10.1177/2040620713519729
  2. Giudicelli, V., Chaume, D., & Lefranc, M.-P. (2005). IMGT/GENE-DB: a comprehensive database for human and mouse immunoglobulin and T cell receptor genes. Nucleic Acids Research, 33(suppl 1), D256-D261. doi:10.1093/nar/gki010
  3. Invivoscribe. (2017). LymphoTrack TRG Assay -MiSeq. 280323 Rev. N - Feb. 2017.
  4. Lymphoma Research Foundation. (2017, June 07). Retrieved from http://www.lymphoma.org/Tcell: www.lymphoma.org/Tcell
  5. Pimpinelli, N., Olsen, E. A., Santucci, M., Vonderheid, E., Haeffner, A. C., Stevens, S., . . . Sa. (2017). Defining early mycosis fungoides. Journal of the American Academy of Dermatology, 53(6), 1053-1063. doi:10.1016/j.jaad.2005.08.057
  6. Schumacher, J. A., Duncavage, E. J., Mosbruger, T. L., Szankasi, P. M., & Kelley, T. W. (2014). A Comparison of Deep Sequencing of TCRG Rearrangements vs Traditional Capillary Electrophoresis for Assessment of Clonality in T-Cell Lymphoproliferative Disorders. American Journal of Clinical Pathology, 141(3), 348-359. doi:10.1309/AJCP5TYGBVW4ZITR
  7. Sufficool, K. E., Lockwood, C. M., Abel, H. J., Hagemann, I. S., Schumacher, J. A., Kelley, T. W., & Duncavage, E. J. (2015). T-cell clonality assessment by next-generation sequencing improves detection sensitivity in mycosis fungoides. Journal of the American Academy of Dermatology, 73(2), 228-236.e2.
  8. van Dongen, J., Langerak, A., Brüggemann, M., Evans, P., Hummel, M., Lavender, F., . . . Macintyre, E. (2003). Design and standardization of PCR primers and protocols for detection of clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations: Report of the BIOMED-2 Concerted Action BMH4-CT98-3936. Leukemia, 17, 2257-2317.
  9. Wilcox, R. A. (2014). Cutaneous T-cell lymphoma: 2014 Update on diagnosis, risk-stratification, and management. American Journal of Hematology, 89(8), 837-851. doi:10.1002/ajh.23756
  10. Willemze, R., Jaffe, E. S., Burg, G., Cerroni, L., Berti, E., Swerdlow, S. H., . . . Kurrer, M. (2005). WHO-EORTC classification for cutaneous lymphomas. Blood, 105(10), 3768-3785. doi:10.1182/blood-2004-09-3502