T-Cell Receptor Gene Rearrangements Profile, γ and β

CPT: 81340; 81342
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Test Details

Synonyms

  • TCRB Gene Clonality Assay
  • TCRG Gene Clonality Assay

Use

This profile can be used to detect clonal T-cell receptor γ-chain (TCRG) and β-chain (TCRB) gene rearrangements in blood, bone marrow, and tissue specimens with a combined T-cell clonality detection rate of 94% to 99%. The presence of a monoclonal gene rearrangement usually, but not always, reflects the presence of a T-lymphocytic neoplasm, while polyclonal gene rearrangement patterns are found in benign reactive conditions. Thus, the results of these studies can assist in the diagnosis of lymphoproliferative disorders.

Limitations

This PCR assay is able to detect a clonal DNA population at the sensitivity of 5% in a background of polyclonal DNA.

Methodology

Polymerase chain reaction (PCR)

Specimen Requirements

Specimen

Whole blood, bone marrow, formalin-fixed, paraffin-embedded (FFPE) tissue block or slides, fresh or frozen tissue

Volume

3 to 5 mL whole blood, 1 mL bone marrow, five unstained slides at 10 μM or formalin-fixed, paraffin-embedded tissue block, tissue in RPMI or frozen.

Minimum Volume

0.5 mL whole blood, 0.5 mL bone marrow, two unstained slides at 10 μM

Container

Lavender-top (EDTA) tube, green-top (heparin) tube, slides, blocks, tissue in RPMI, or frozen

Collection

Fresh tissue should be placed in RPMI medium or shipped frozen on dry ice. Also acceptable are small samples (eg, punch biopsies, fine-needle aspirate).

Storage Instructions

Maintain blood, bone marrow or tissue in RPMI at 2°-8°C, FFPE specimens at room temperature, frozen tissue at -80°C

Causes for Rejection

Frozen whole blood/bone marrow; tumor block containing no tumor tissue; broken or stained slides; quantity not sufficient for analysis

Clinical Information

Special Instructions

Please direct any questions regarding this test to customer service at 800-345-4363.

References

Brüggemann M, White H, Gaulard P, et al. Powerful strategy for polymerase chain reaction-based clonality assessment in T-cell malignancies: Report of the BIOMED-2 concerted action BHM4-CT98-3936. Leukemia. 2007 Feb; 21(2): 215-221.17170730
Langerak AW, Groenen PJ, Brüggemann M, et al. EuroClonality/BIOMED-2 guidelines for interpretation and reporting of Ig/TCR clonality testing in suspected lymphoproliferations. Leukemia. 2012 Oct; 26(10): 2159-2171.22918122
van Krieken JH, Langerak AW, Macintyre EA, et al. Improved reliability of lymphoma diagnostics via PCR-based clonality testing: Report of the BIOMED-2 concerted action BHM4-CT98-3936. Leukemia. 2007 Feb; 21(2): 201-206.17170732

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
481080 T Cell Panel (gamma, beta) 480709 T-Cell PCR Interpretation 21753-9
481080 T Cell Panel (gamma, beta) 480826 T Clonal Size N/A
481080 T Cell Panel (gamma, beta) 481156 Block Number: N/A
481080 T Cell Panel (gamma, beta) 489024 Director Review: 72486-4
481080 T Cell Panel (gamma, beta) 480711 Methodology: 49549-9
481080 T Cell Panel (gamma, beta) 480821 References: N/A
481080 T Cell Panel (gamma, beta) 511824 Putaway N/A
481080 T Cell Panel (gamma, beta) 480986 TCRB Gene Clonality Results: 21751-3
481080 T Cell Panel (gamma, beta) 480987 Clonal Size: N/A
481080 T Cell Panel (gamma, beta) 480989 Block Number: N/A
481080 T Cell Panel (gamma, beta) 480993 Director Review: 72486-4
481080 T Cell Panel (gamma, beta) 480984 Methodology: 49549-9
481080 T Cell Panel (gamma, beta) 480994 References: N/A
481080 T Cell Panel (gamma, beta) 511974 Putaway N/A

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