Assessment of clonality in T-cell large granular lymphocytic leukemia: flow cytometric T cell receptor Vβ repertoire and T cell receptor gene rearrangement.
The usefulness of flow cytometric variable β-chain repertoire (FC-Vβ) and T-cell receptor gene rearrangement (TCR-GR) analyses for differentiating T-cell large granular lymphocytic leukemia (T-LGLL) from reactive T-large granular lymphocyte (T-LGL) lymphocytosis has been insufficiently studied to date. In this study, we analyzed the diagnostic value of TCR-GR and FC-Vβ analysis in T-LGLL, and compared these results. In our study, FC-Vβ analysis was positive in all cases of T-LGLL, and clonality assessment of FC-Vβ had equal sensitivity and specificity to GeneScanning analysis but was more sensitive than heteroduplex analysis. Suspected T-cell clonality can best be addressed by evaluating two TCR targets (TCRβ and TCRγ), either in parallel or consecutively. Signal transducer and activator of transcription 3 (STAT3) mutation may provide a diagnostic tool for classifying some cases of T-LGL lymphocytosis as true T-LGLL. Our results further demonstrate a significant correlation of STAT3 mutation with pure red cell aplasia, neutropenia, hepatomegaly, β2-microglobulin and anemia.
Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital , Nanjing , China.
Zhi-Yuan
ZY
Qiu
Wen-Yi
WY
Shen
Lei
L
Fan
Li
L
Wang
Hui
H
Yu
Chun
C
Qiao
Yu-Jie
YJ
Wu
Rui-Nan
RN
Lu
Jun
J
Qian
Guang-Sheng
GS
He
Wei
W
Xu
Jian-Yong
JY
Li
D000368:Aged; D002999:Clone Cells / Q000378:metabolism / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D015321:Gene Rearrangement; D006801:Humans; D054066:Leukemia, Large Granular Lymphocytic / Q000175:diagnosis / Q000235:genetics*; D008218:Lymphocytosis / Q000175:diagnosis / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011948:Receptors, Antigen, T-Cell / Q000235:genetics*; D050796:STAT3 Transcription Factor / Q000235:genetics
D011948:Receptors, Antigen, T-Cell; D050796:STAT3 Transcription Factor
FC-Vβ; GeneScanning; STAT3; T-cell large granular lymphocytic leukemia; TCR-GR; heteroduplex