PCR-based clonality assessment in patients with lymphocytic leukaemias: a single-institution experience |
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Authors: | Bojana M Cikota Ljiljana J Tukić Olivera T Tarabar Dragana T Stamatović Marija N Elez Zvonko M Magić |
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Institution: | (1) Department of Pathology, Radboud University Nijmegen Medical Centre, Geert Grooteplein 24, 6525 GA Nijmegen, The Netherlands;(2) Department of Immunology, Erasmus MC, University Medical Center, Rotterdam, Netherlands |
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Abstract: | PCR-based clonality testing can be performed in all lymphoproliferations by analysing gene rearrangements of antigen receptors,
rearrangements that are unique for each kind of lymphocyte. Reactive lymphoproliferations have polyclonally rearranged Ig/TCR
genes, whereas malignant proliferations (leukaemias and lymphomas) show clonal rearrangements. The aim of this study was to
assess the clinical benefits of clonality testing with previously evaluated consensus primers in leukaemia patients. The study
included peripheral blood and bone marrow samples of 67 leukaemia patients (32 B-CLL, 24 B-ALL and 11 T-ALL). Clonality testing
was based on PCR amplification of rearranged IgH and TCR genes. During diagnosis, monoclonal pattern was found in all analysed
B-CLL and T-ALL samples. Testing in B-ALL patients showed positive results in all bone marrow and one peripheral blood samples.
Results of clonality testing in B-CLL patients during follow-up were concordant between peripheral blood and bone marrow.
Obtained results corresponded to clinical course in all but one patient. In B-ALL group, results of molecular testing in peripheral
blood and bone marrow confirmed remission estimated according to clinical criteria in all except one patient. Before any clinical
sign of relapse, monoclonal pattern was found in six/seven patients by bone marrow and in three/seven patients by peripheral
blood analysis, respectively. Results of molecular monitoring in T-ALL patients did not confirme clinical evaluation in two
patients. Obtained results indicate high accuracy of re-evaluated primers for clonality assessment in ALL and CLL patients
at the time of diagnosis. Results of clonality testing in B-ALL patients indicate that bone marrow analysis has higher sensitivity
compared to analysis of peripheral blood. |
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