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Int J Med Sci 2013; 10(11):1510-1517. doi:10.7150/ijms.5342 This issue Cite

Research Paper

Analysis of Immunoglobulin and T Cell Receptor Gene Rearrangement in the Bone Marrow of Lymphoid Neoplasia Using BIOMED-2 Multiplex Polymerase Chain Reaction

Soyoung Shin¹, Ah Hyun Kim¹, Joonhong Park¹, Myungshin Kim^1✉, Jihyang Lim¹, Yonggoo Kim¹, Kyungja Han¹, Sun Ah Lee², Seok-Goo Cho³

1. Department of Laboratory Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea;
2. Blood Transfusion Research Institute, Korean Red Cross, Seoul, Korea;
3. Department of Hematology, Catholic Blood and Marrow Transplantation Center, The Catholic University of Korea, College of Medicine, Seoul, Korea.

✉ Corresponding author: Myungshin Kim, M.D., Ph D., Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul 137-701, Korea (South). Telephone: +82-2-2258-1645; Fax: +82-2-2258-1719; E-mail: microkimac.kr. More

Abstract

The evaluation of bone marrow (BM) involvement is important for diagnosis and staging in patients with lymphoid neoplasia. We evaluated of immunoglobulin (Ig) and/or T-cell receptor (TCR) gene rearrangements in the BM using the standardized BIOMED-2 multiplex PCR clonality assays and compared the results with microscopic findings such as histology and CD10, CD20, CD79a, CD3 and CD5 immunohistochemistry. A total of 151 samples were enrolled; 119 B cell neoplasia, 29 T cell neoplasia, and 3 Hodgkin's lymphoma. The molecular clonality assay and microscopic diagnosis were concordant in 66.9% (n=101) and discordant in 33.1 % (n=50). Ig/TCR gene clonality assay detected 43 cases of BM involvement which was not presented in the morphology. Two cases among them turned into microscopic BM involvement during a close follow up. Clonal TCR gene rearrangements were detected in 12.6% of B cell neoplasia and Ig gene rearrangement were found in 3.4% of T cell neoplasia. This molecular clonality assay is valuable particularly in diagnosing BM involvement of lymphoid neoplasia if it is morphologically uncertain. But it should be carefully interpreted because molecular clonality may be present in the reactive lymphoproliferation. Therefore, comprehensive analysis with morphologic analysis should be important to reach a final diagnosis.

Keywords: immunoglobulin (Ig) /T-cell receptor (TCR) gene rearrangements, BIOMED-2 multiplex PCR.

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