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Updated: May 13, 2026

T and B Cell Receptor Immune Repertoire Analysis using Next-generation Sequencing
Published on: January 12, 2021
Immunoglobulin/T-cell receptor clonality diagnostics
Anton W Langerak1, Patricia Jta Groenen, J Han Jm van Krieken
1Erasmus MC, University Medical Center, Department of Immunology, Dr Molewaterplein 50, 3015 GE Rotterdam, The Netherlands +31 10 40 88089 ; +31 10 40 89456 ; a.langerak@erasmusmc.nl.
Abstract:
Clonality testing in lymphoid malignancies has become technically relatively easy to perform in routine laboratories using standardized multiplex polymerase chain reaction protocols for Ig/T-cell receptor (TCR) gene analysis. Expertise with clonality diagnostics and knowledge about the biology of Ig/TCR recombination are essential for correct interpretation of the Ig/TCR clonality data. Several immunobiologic and technical pitfalls that should be taken into account to avoid misinterpretation of data are addressed in this review. Furthermore, the need to integrate the molecular data with that from (hemato-)pathology, and preferably also flowcytometric immunophenotyping for appropriate interpretation, is discussed. Such an interactive, multidisciplinary diagnostic model guarantees integration of all available data to reach the most reliable diagnosis.
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