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Hu G, Hauk PJ, Zhang N, Elsegeiny W, Guardia CM, Kullas A, Crosby K, Deterding RR, Schedel M, Reynolds P, Abbott JK, Knight V, Pittaluga S, Raffeld M, Rosenzweig SD, Bonifacino JS, Uzel G, Williamson PR, Gelfand EW. Autophagy-associated immune dysregulation and hyperplasia in a patient with compound heterozygous mutations in ATG9A. Autophagy 2023; 19:678-691. [PMID: 35838483 PMCID: PMC9851204 DOI: 10.1080/15548627.2022.2093028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 01/27/2023] Open
Abstract
ABBREVIATIONS BCL2: BCL2 apoptosis regulator; BCL10: BCL10 immune signaling adaptor; CARD11: caspase recruitment domain family member 11; CBM: CARD11-BCL10-MALT1; CR2: complement C3d receptor 2; EBNA: Epstein Barr nuclear antigen; EBV: Epstein-Barr virus; FCGR3A; Fc gamma receptor IIIa; GLILD: granulomatous-lymphocytic interstitial lung disease; HV: healthy volunteer; IKBKB/IKB kinase: inhibitor of nuclear factor kappa B kinase subunit beta; IL2RA: interleukin 2 receptor subunit alpha; MALT1: MALT1 paracaspase; MS4A1: membrane spanning 4-domain A1; MTOR: mechanistic target of rapamycin kinase; MYC: MYC proto-oncogene, bHLH: transcription factor; NCAM1: neural cell adhesion molecule 1; NFKB: nuclear factor kappa B; NIAID: National Institute of Allergy and Infectious Diseases; NK: natural killer; PTPRC: protein tyrosine phosphatase receptor type C; SELL: selectin L; PBMCs: peripheral blood mononuclear cells; TR: T cell receptor; Tregs: regulatory T cells; WT: wild-type.
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Affiliation(s)
- Guowu Hu
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Pia J Hauk
- Divisions of Allergy and Immunology and Cell Biology and Immunodeficiency Diagnosis and Treatment Program, Department of Pediatrics, National Jewish Health, Denver, CO, USA
- Section Pediatric Allergy and Immunology, Children’s Hospital, Colorado, Aurora, CO, USA
| | - Nannan Zhang
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Waleed Elsegeiny
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Carlos M. Guardia
- Section on Intracellular Protein Trafficking, Neurosciences and Cellular and Structural Biology Division, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Amy Kullas
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Kevin Crosby
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Robin R. Deterding
- Section Pediatric Pulmonary Medicine, Children’s Hospital, Colorado, Aurora, CO, USA
| | - Michaela Schedel
- Divisions of Allergy and Immunology and Cell Biology and Immunodeficiency Diagnosis and Treatment Program, Department of Pediatrics, National Jewish Health, Denver, CO, USA
- Department of Pulmonary Medicine, University Medicine Essen-Ruhrlandklinik, Essen, Germany
- Department of Pulmonary Medicine, University Medicine Essen, University Hospital, Essen, Germany
| | - Paul Reynolds
- Divisions of Allergy and Immunology and Cell Biology and Immunodeficiency Diagnosis and Treatment Program, Department of Pediatrics, National Jewish Health, Denver, CO, USA
| | - Jordan K Abbott
- Divisions of Allergy and Immunology and Cell Biology and Immunodeficiency Diagnosis and Treatment Program, Department of Pediatrics, National Jewish Health, Denver, CO, USA
- Section Pediatric Allergy and Immunology, Children’s Hospital, Colorado, Aurora, CO, USA
| | - Vijaya Knight
- Section Pediatric Allergy and Immunology, Children’s Hospital, Colorado, Aurora, CO, USA
| | - Stefania Pittaluga
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Mark Raffeld
- Immunology Service, Department of Laboratory Medicine, NIH Clinical Center, Bethesda, MD, USA
| | - Sergio D. Rosenzweig
- Immunology Service, Department of Laboratory Medicine, NIH Clinical Center, Bethesda, MD, USA
| | - Juan S. Bonifacino
- Section on Intracellular Protein Trafficking, Neurosciences and Cellular and Structural Biology Division, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Gulbu Uzel
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Peter R. Williamson
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Erwin W. Gelfand
- Divisions of Allergy and Immunology and Cell Biology and Immunodeficiency Diagnosis and Treatment Program, Department of Pediatrics, National Jewish Health, Denver, CO, USA
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Torre P, Brescia A, Giurato G, D’Auria R, Rizzo F, Motta BM, Giudice V, Selleri C, Zeppa P, Caputo A, Casolaro V, Persico M. Mucosal-Associated Invariant T Cells in T-Cell Non-Hodgkin Lymphomas: A Case Series. Cancers (Basel) 2022; 14:cancers14122921. [PMID: 35740587 PMCID: PMC9221487 DOI: 10.3390/cancers14122921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 06/09/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Mucosal-associated invariant T (MAIT) cells are a subgroup of T lymphocytes whose role has recently been investigated in several types of diseases, including cancer. However, little is known about these cells in lymphomas. In this case series, we investigated the presence of MAIT cells in biopsies obtained from patients diagnosed with T-cell non-Hodgkin lymphomas, uncommon hematological malignancies with often not clearly defined etiopathology. Abstract Background: Mucosal-associated invariant T (MAIT) cells are a subset of unconventional T lymphocytes expressing a semi-invariant α/β T-cell receptor (TCR). The physiological functions of these cells, which are particularly abundant in normal liver and mucosal sites, have become clear only in recent years, but their role in most human diseases is still unknown. Since the cellular origin and etiopathogenesis of most T-lymphomas are still elusive, we decided to explore the presence of MAIT cells in biopsies from these neoplasms. Methods: Sixteen biopsies obtained from patients with a T-cell lymphoma diagnosis were analyzed via immunofluorescence staining using an anti-Vα7.2 antibody and the MR1-antigen tetramer. Positive cases were subjected to a polymerase chain reaction for the detection of Vα7.2–Jα33, Vα7.2–Jα20, or Vα7.2–Jα12 rearrangements, followed by sequencing of the CDR3α region. Results: CD3+/Vα7.2+ and CD3+/MR1-Ag-tetramer+ cells were found in 4 of 16 samples analyzed. The identification of specific TCR rearrangements confirmed the presence of these cells in all four samples. PCR and sequencing results documented the presence of multiple clones of MAIT cells in each positive sample. Conclusions: MAIT cells are frequently found in T-cell lymphomas. More in-depth studies and a larger number of samples are needed to better clarify the contribution of MAIT cells to this rare neoplasm.
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Affiliation(s)
- Pietro Torre
- Internal Medicine and Hepatology Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, University of Salerno, 84131 Salerno, Italy;
| | - Annalisa Brescia
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (A.B.); (G.G.); (R.D.); (F.R.); (B.M.M.); (V.C.)
| | - Giorgio Giurato
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (A.B.); (G.G.); (R.D.); (F.R.); (B.M.M.); (V.C.)
| | - Raffaella D’Auria
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (A.B.); (G.G.); (R.D.); (F.R.); (B.M.M.); (V.C.)
| | - Francesca Rizzo
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (A.B.); (G.G.); (R.D.); (F.R.); (B.M.M.); (V.C.)
| | - Benedetta Maria Motta
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (A.B.); (G.G.); (R.D.); (F.R.); (B.M.M.); (V.C.)
| | - Valentina Giudice
- Hematology and Transplant Center, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, University of Salerno, 84131 Salerno, Italy; (V.G.); (C.S.)
| | - Carmine Selleri
- Hematology and Transplant Center, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, University of Salerno, 84131 Salerno, Italy; (V.G.); (C.S.)
| | - Pio Zeppa
- Pathology Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, University of Salerno, 84131 Salerno, Italy; (P.Z.); (A.C.)
| | - Alessandro Caputo
- Pathology Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, University of Salerno, 84131 Salerno, Italy; (P.Z.); (A.C.)
| | - Vincenzo Casolaro
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (A.B.); (G.G.); (R.D.); (F.R.); (B.M.M.); (V.C.)
| | - Marcello Persico
- Internal Medicine and Hepatology Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, University of Salerno, 84131 Salerno, Italy;
- Correspondence:
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Trum N, Zain J, Martinez X, Parekh V, Afkhami M, Abdulla F, Carson K, Rosen S, Bennett C, Querfeld C. Mogamulizumab efficacy is underscored by its associated rash that mimics cutaneous T-cell lymphoma: a retrospective single-centre case series. Br J Dermatol 2022; 186:153-166. [PMID: 34427917 PMCID: PMC8738116 DOI: 10.1111/bjd.20708] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Mogamulizumab is a humanized antibody against chemokine receptor type 4. It was recently approved by the US Food and Drug Administration for relapsed or refractory mycosis fungoides (MF) and Sézary syndrome (SS). The most commonly reported adverse event in the phase III licensing trial was drug eruption (28%), now termed mogamulizumab-associated rash (MAR). Clinical recommendations about MAR and its treatment differ between the current package insert and postapproval insights reported from two single-centre studies that focused on its characterization, but less so on outcomes and clinicopathological differentiation from cutaneous T-cell lymphoma (CTCL). OBJECTIVES To describe our experience in the diagnosis of MAR and treatment of patients with CTCL with mogamulizumab. METHODS This is a single-centre retrospective case series study. RESULTS We found a higher incidence of MAR in patients with CTCL (17 of 24, 68%) than previously reported. MAR development is associated with complete (11 of 17) or partial (four of 17) responses, with an overall response rate of 88%, compared with 29% (two of seven) in patients without MAR. Diagnosis of MAR may be obscured by its ability to mimic key CTCL features both clinically and histologically, but an absence of T-cell-receptor clonality and relatively decreased CD4 : CD8 ratio compared with baseline lesions strongly favour MAR over recurrent disease. CONCLUSIONS MAR has the potential to create a significant management problem for patients on mogamulizumab. Misidentification of MAR as recurrent CTCL may detrimentally result in the premature discontinuation of mogamulizumab in patients whose disease is historically hard to treat. Thorough clinicopathological investigation of new lesions during treatment with mogamulizumab is required to inform ideal treatment decisions and achieve better outcomes.
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Affiliation(s)
- N.A. Trum
- Division of Dermatology, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States,Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel
| | - J. Zain
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States
| | - X.U. Martinez
- Division of Dermatology, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States
| | - V. Parekh
- Department of Pathology, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States
| | - M. Afkhami
- Department of Pathology, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States
| | - F. Abdulla
- Division of Dermatology, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States
| | - K.R. Carson
- Division of Hematology, Oncology, and Stem Cell Transplant, Rush University, 600 S. Paulina St., Chicago, Illinois 60612, United States
| | - S.T. Rosen
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States,Beckman Research Institute, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States
| | - C.L. Bennett
- Department of Comparative Medicine and Evidence Based Medicine, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States,Beckman Research Institute, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States,College of Pharmacy, University of South Carolina
| | - C. Querfeld
- Division of Dermatology, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States,Department of Pathology, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States,Beckman Research Institute, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States
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Hwang JK, Wang E, Neff JL, Wang J. A Cautionary Tale: Florid Splenic γδ T-cell Proliferation and False-Positive T-cell Clonality by PCR Leads to a Grave Misdiagnosis. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2021; 21:e748-e751. [PMID: 34158266 DOI: 10.1016/j.clml.2021.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/05/2021] [Accepted: 05/16/2021] [Indexed: 11/15/2022]
Abstract
The discrimination of benign from malignant lymphoproliferative disorders is sometimes difficult because there can be overlap in their histological and immunophenotypic features. In such situations, molecularly based clonality testing is often used to discriminate benign (polyclonal) from malignant (monoclonal) processes. Clonality testing by polymerase chain reaction (PCR) has a number of pitfalls that may result in spurious results. Here we report the case of a woman diagnosed by 2 major academic institutions with hepatosplenic T-cell lymphoma based on a dense infiltration of the spleen by a γδ T-cell population with mild cytologic atypia, resulting in expansion of the splenic red pulp, and a positive T-cell receptor clonality test by PCR. There was likewise mild involvement of the liver and bone marrow by the "atypical" T-cell population. Close attention to her uncharacteristically well clinical appearance led to repeat T-cell receptor clonality testing using next-generation sequencing. Definitive demonstration of polyclonality by this test showed that she in fact did not have hepatosplenic T-cell lymphoma but rather a reactive condition, and allogeneic stem cell transplantation could be safely avoided. As molecular clonality testing is widely used in the practice of hematology, this case brings attention to the pitfalls of clonality testing by PCR that practitioners may encounter. It is therefore a cautionary tale highlighting the need for critical interpretation of test results in full clinical context.
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Affiliation(s)
- Joyce K Hwang
- Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Endi Wang
- Department of Pathology, Duke University Medical Center, Durham, North Carolina
| | - Jadee L Neff
- Department of Pathology, Duke University Medical Center, Durham, North Carolina
| | - Jie Wang
- Department of Medicine, Division of Hematologic Malignancies and Cellular Therapies, Duke Cancer Institute, Durham, North Carolina.
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Ho CC, Tung JK, Zehnder JL, Zhang BM. Validation of a Next-Generation Sequencing-Based T-Cell Receptor Gamma Gene Rearrangement Diagnostic Assay: Transitioning from Capillary Electrophoresis to Next-Generation Sequencing. J Mol Diagn 2021; 23:805-815. [PMID: 33892183 DOI: 10.1016/j.jmoldx.2021.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 03/15/2021] [Accepted: 03/25/2021] [Indexed: 01/23/2023] Open
Abstract
Assessment of T-cell receptor γ gene (TRG) rearrangements is an importants consideration in the diagnostic workup of lymphoproliferative diseases. Although fragment analysis by PCR and capillary electrophoresis (CE) is the current standard of such assessment in clinical molecular diagnostic laboratories, it does not provide sequence information and is only semi-quantitative. Next-generation sequencing (NGS)-based assays are an attractive alternative to the conventional fragment size-based methods, given that they generate results with specific clonotype sequence information and allow for more accurate quantitation. The present study evaluated various test parameters and performance characteristics of a commercially available NGS-based TRG gene-rearrangement assay by testing 101 clinical samples previously characterized by fragment analysis. The NGS TRG assay showed an overall accuracy of 83% and an analytical specificity of 100%. The concordance rates were 88% to 95% in the Vγ1-8, Vγ10, and Vγ11 gene families, but lower in the Vγ9 gene family. This difference was mostly attributed to the incomplete polyclonal symmetry resulting from the two-tube CE assay versus the one-tube design of the NGS assay. The NGS assay also demonstrated strengths in distinguishing clonotypes of the same fragment size. This clinical validation demonstrated robust performance of the NGS-based TRG assay and identified potential pitfalls associated with CE assay design that are important for understanding the observed discrepancies with the CE-based assay.
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Affiliation(s)
- Chandler C Ho
- Molecular Pathology Laboratory, Stanford Health Care, Stanford, California
| | - Jack K Tung
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - James L Zehnder
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Bing M Zhang
- Department of Pathology, Stanford University School of Medicine, Stanford, California.
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Agarwal I, Sabatini L, Alikhan MB. Diagnostic Capability of Next-Generation Sequencing Fusion Analysis in Identifying a Rare CASE of TRAF1-ALK-Associated Anaplastic Large Cell Lymphoma. Front Oncol 2020; 10:730. [PMID: 32457846 PMCID: PMC7225296 DOI: 10.3389/fonc.2020.00730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 04/16/2020] [Indexed: 12/02/2022] Open
Abstract
Background: Anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL) is a rare T-cell neoplasm, accounting for approximately 3% of adult non-Hodgkin lymphomas. Although NPM1 is the most common fusion partner with ALK, many others have been described, necessitating break-apart FISH studies for confirmation of the diagnosis. TNF receptor-associated factor 1 (TRAF1) is a rare ALK partner that is thought to confer a worse prognosis in patients. We describe the utility of next-generation sequencing (NGS) RNA analysis in detection of this uncommon ALK partner. Case Description: A 42-year-old male with cervical lymphadenopathy presented for excisional biopsy. Following a tissue diagnosis of ALCL, ALK+, RNA from the biopsy was extracted from Formalin-fixed paraffin-embedded (FFPE) tissue and prepared for Anchored Multiplex PCR using the Archer® FusionPlex® v2 assay, which employs unidirectional gene-specific primers using NGS to detect novel or unknown gene partners. Results: Histologic evaluation of the excised lymph node showed atypical cells, including “horseshoe/kidney”-shaped nuclei. Neoplastic cells were immunoreactive against CD30, ALK (diffuse, cytoplasmic), CD2, CD4, granzyme B, and TIA-1. A diagnosis of ALCL, ALK+ was made. The pattern of ALK immunostaining suggested a non-NPM1-associated ALK translocation pattern, prompting further investigation. NGS fusion analysis showed a translocation involving exon 7 of TRAF1 and exon 20 of ALK. Conclusion: ALK positivity suggests an overall favorable prognosis of ALCL as compared to ALK-negative cases. However, in the rare published cases of TRAF1-ALK, an aggressive clinical course has been observed, which may reflect the aggressive propensity of this particular fusion, as these cases appear to be refractory to standard chemotherapy and also to the first generation ALK inhibitors. This study highlights the advantage of using NGS in RNA-based fusion assays to detect rare translocations, which can be of some clinical importance in detecting rare but aggressive fusion partners of ALK. As these technologies become more available, there is potential to identify such changes and effectively stratify the prognosis of ALCL patients.
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Affiliation(s)
- Indu Agarwal
- Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, IL, United States
| | - Linda Sabatini
- Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, IL, United States
| | - Mir B Alikhan
- Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, IL, United States
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A New and Simple TRG Multiplex PCR Assay for Assessment of T-cell Clonality: A Comparative Study from the EuroClonality Consortium. Hemasphere 2019; 3:e255. [PMID: 31723840 PMCID: PMC6746026 DOI: 10.1097/hs9.0000000000000255] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 04/11/2019] [Indexed: 11/25/2022] Open
Abstract
Supplemental Digital Content is available in the text T-cell Receptor Gamma (TRG) rearrangements are commonly used to detect clonal lymphoproliferations in hematopathology, since they are rearranged in virtually all T lymphocytes and have a relatively limited recombinatorial repertoire, which reduces the risk of false negative results, at the cost of potential false positivity. We developed an initial one-tube, 2-fluorochrome EuroClonality TRG PCR multiplex (TRG-1T-2F) which was compared to the original 2-tube, 2-fluorochrome EuroClonality/BIOMED-2 TRG PCR (TRG-2T-2F) and a commercial Invivoscribe one-tube, one-fluorochrome kit (IVS-1T-1F) on a series of 239 samples, including both T-cell malignancies and reactive cases. This initial assay yielded discrepant results between the 10 participating EuroClonality laboratories when using 2 fluorochromes, leading to adoption of a final single color EuroClonality strategy (TRG-1T-1F). Compared to TRG-2T-2F, both TRG-1T-1F and IVS-1T-1F demonstrated easier interpretation and a lower risk of false positive from minor peaks in dispersed repertoires. Both generate smaller fragments and as such are likely to be better adapted to analysis of formalin-fixed paraffin-embedded (FFPE) tissue samples. Their differential performance was mainly explained by (i) superposition of biallelic rearrangements with IVS-1T-1F, due to more extensive overlapping of the repertoires and (ii) intentional omission of the TRGJP primer in TRG-1T-1F, in order to avoid the potential risk of confusion of consensus TRG V9-JP normal rearrangements with a pathological clone.
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Frizinsky S, Rechavi E, Barel O, Najeeb RH, Greenberger S, Lee YN, Simon AJ, Lev A, Ma CA, Sun G, Blackstone SA, Milner JD, Somech R, Stauber T. Novel MALT1 Mutation Linked to Immunodeficiency, Immune Dysregulation, and an Abnormal T Cell Receptor Repertoire. J Clin Immunol 2019; 39:401-413. [DOI: 10.1007/s10875-019-00629-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 04/09/2019] [Indexed: 02/06/2023]
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