VH AND TCRG gene rearrangements (Molecular pathology tests)

These PCR assays are routinely used for the identification of clonal B and/or T-cell populations.

The VH assay amplifies the DNA between primers that target the conserved framework and joining regions which lie on either side of an area within the V-J region where programmed genetic rearrangements occur during maturation of all B lymphocytes. The genes which undergo rearrangement are the immunoglobulin heavy chain and light chain genes, with each B-cell having a V-J rearrangement that is unique in length and sequence. Consequently amplification of this region will result in one or two amplicons in a clonal population and a Gaussian distribution of amplicons in normal and polyclonal populations of cells.

The TCRG gene locus includes 14 V genes, 5 J segments and 2 C genes. The TCRG assay, using the same concept as the VH assay, detects the majority of TCR gamma gene rearrangements. As above, clonality is indicated if one or two amplicons result from the assay.

These tests can be used to identify clonal populations of B or T-cells, to determine lineage of lymphomas and leukaemias and to evaluate and assess disease recurrence or residual disease.

The following is an extract from the BIOMED-2 Concerted Action Reports, Leukemia 2007; 21; 201-206.

“In this era of increased attention for quality improvement in medicine, we believe that the introduction of the BIOMED-2 clonality assays lead to a more reliable diagnosis and thus to a better care for patients who are suspected to have a malignant lymphoma.”

Sample type and Volume required: 
Paraffin processed blocks or sections of tissue.

5 µg of extracted genomic DNA.

5mm cube of frozen tissue.

Because of the possibility of lineage infidelity, VH and TCR analysis will both be performed in all cases.

Entire case referrals are also welcome for which representative paraffin blocks will be suitable.

Turnaround time: 
2 Weeks
Cellular Pathology at Guy's And St Thomas' Hospital
Histology: 0207 188 8468, Cytology: 0207 188 2915, Oral Pathology: 0207 188 4367
Histopathology & Cytopathology Laboratories
Cellular Pathology
St Thomas' Hospital
North Wing - 2nd Floor
Westminster Bridge Road
London SE1 7EH

Head and Neck/Oral Pathology Laboratory
4th Floor, Tower Wing
Guy's Hospital
Great Maze Pond
London SE1 9RT

For clinical advice or interpretation of results, please contact the laboratory in the first instance.

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Last updated: 07/08/2015