title: [Study of immunoglobulin and T-cell receptor gene rearrangements in patients with non-Hodgkin's lymphoma].
abstract: OBJECTIVE
  To investigate immunoglobulin (Ig) and T cell receptor (TCR) gene rearrangements in bone marrow or peripheral blood of patients with non-Hodgkin's lymphoma (NHL), and to explore the potential clinical significance.
  
  
  METHODS
  The Ig/TCR gene rearrangements in bone marrow or peripheral blood of 139 NHL patients were analyzed by using BIOMED-2 multiple primers system and Multiplex PCR assay.
  
  
  RESULTS
  Ig clonality was detected in 85.4% (70/82) of chronic lymphocytic leukemia (CLL), including 46.3% (38/82) IgH rearrangement, 62.2% (51/82) IgK rearrangement and 1.2% (1/82) IgL rearrangement, and in 39.4% (13/33) of other categories of B-lineage NHL (B-NHL), including 33.3% (11/33) IgH and 39.4% (13/33) IgK rearrangements. TCR clonality was detected in 50.0% (12/24) of all definite T-lineage NHL (T-NHL), including 8.3% (2/24) TCRB and 45.8% (11/24) TCRG, no TCRD was detected. The detection rate of gene rearrangements of NHL diversed in different clinical stages \[36.4% in early stage (Ann Arbor stage I and II) and 45.6% in late stage (III and IV)\] and in different degrees of malignancy (40.0% indolent NHL and 45.6% aggressive NHL), but no obvious statistical significance was obtained (P > 0.05). The detection rate of bone marrow invasions of NHL (except CLL) with examinations of bone marrow smear under the microscope was 12.3% (7/57), much lower than the clonality testing (43.9%, 25/57) (P < 0.05). Sensitivity test showed that the sensitivity of malignant clonality testing by multiplex PCR was 3.12% - 6.25%.
  
  
  CONCLUSIONS
  The detection rate of gene rearrangements diverses in different clinical stages and degrees of malignancy of NHL, but the correlation has not been proved in this research. The sensitivity of multiplex PCR-based clonality testing is enhanced with the combination of BIOMED-2 primers system. It is more sensitive than the morphological examinations of bone marrow smear in detecting bone marrow invasions, and may provide a powerful strategy in the routine diagnosis and assessment after treatment.
authors.affiliation: Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Ruo-qi
authors.initials: RQ
authors.lastname: Wu
authors.forename: Chun
authors.initials: C
authors.lastname: Qiao
authors.forename: Yi
authors.initials: Y
authors.lastname: Tong
authors.forename: Zheng
authors.initials: Z
authors.lastname: Ge
authors.forename: Jian-fu
authors.initials: JF
authors.lastname: Zhang
authors.forename: Yu-Jie
authors.initials: YJ
authors.lastname: Wu
authors.forename: Hai-rong
authors.initials: HR
authors.lastname: Qiu
authors.forename: Zhi
authors.initials: Z
authors.lastname: Wang
authors.forename: Peng
authors.initials: P
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015329:Gene Rearrangement, T-Lymphocyte; D019672:Genes, T-Cell Receptor / Q000235:genetics*; D006801:Humans; D007136:Immunoglobulins / Q000235:genetics*; D008228:Lymphoma, Non-Hodgkin / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction
chemical_list: D007136:Immunoglobulins