NDLI: Clinical Experience With Modified, Single-Tube T-Cell Receptor Vβ Flow Cytometry Analysis for T-Cell Clonality

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Wu, David Anderson, Melanie M. Othus, Megan Wood, Brent L.
Description	Author Affiliation: Wu D ( From the Department of Laboratory Medicine, University of Washington, Seattle); Anderson MM ( From the Department of Laboratory Medicine, University of Washington, Seattle); Othus M ( Biostatistics and Biomathematics, Fred Hutchinson Cancer Research Center, Public Health Sciences, Seattle, WA.); Wood BL ( From the Department of Laboratory Medicine, University of Washington, Seattle)
Abstract	Objectives: Analysis of T-cell clonality using the IO Test Beta Mark (Beckman Coulter, Fullerton, CA) flow cytometry assay is cumbersome owing to the required eight-part analyses that limit its clinical utility. Here, we describe a simple modification that may improve its clinical utility. Methods: By simply combining all T-cell receptor (TCR) Vβ antibodies into one reagent tube, we show that T-cell repertoire analysis can be efficiently performed with an increased potential to closely link the aberrant immunophenotype of a neoplastic T-cell clone to its apparent clonal TCR Vβ restriction. We review our clinical experience and include flow cytometry sorting studies in conjunction with TRG gene rearrangement analysis to demonstrate the feasibility of this approach. Results: We show in representative cases that this modified approach permits evaluation of TCR Vβ clonality in T-cell neoplasms without a priori knowledge of the TCR Vβ isoform restriction and that this approach is suitable for samples containing a minor population of neoplastic T cells, hypocellular samples such as skin biopsy specimens and body fluids, and fine-needle aspirations. We estimate a false-positive rate for identifying a clonal population for this approach to be less than 6.2%. Conclusions: Our modified approach of TCR Vβ analysis could improve routine clinical evaluation for abnormal T-cell populations by flow cytometry.
File Format	HTM / HTML
ISSN	00029173
e-ISSN	19437722
Journal	American Journal of Clinical Pathology
Issue Number	4
Volume Number	145
Language	English
Publisher	Oxford University Press
Publisher Date	2016-04-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Pathology
Content Type	Text
Resource Type	Article
Subject	Pathology and Forensic Medicine

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