TRBC1/TRBC2 Immunophenotyping Provides Added Value During the Diagnostic Workup of T-Cell Lymphoma
Joseph Taylor1,2, Tasneem Lakum3, Shaun Bevan3,4
1Department of Clinical Haematology Royal London Hospital Barts Health NHS Trust London UK.
Background:
Molecular T-cell receptor (TCR) clonality testing cannot link clonality to immunophenotype, limiting discrimination between malignant and clonal reactive T-cell expansions.
Methods:
We evaluated TRBC1/TRBC2 immunophenotyping in 50 consecutive cases with suspected T-cell malignancy, assessing restriction (ratio > 10) across T-cell subsets.
Results:
TRBC immunophenotyping showed 100% sensitivity for T-cell malignancy if assessed within subsets or phenotypically abnormal populations. Malignant clones predominantly showed CD4αβ/CD8αβ restriction (18/21), while reactive clones predominantly showed γδ/dual-positive/dual-negative restriction (15/16), enabling enhanced discrimination.
Conclusion:
TRBC immunophenotyping provides sensitive clonality detection with phenotypic lineage assignment, adding diagnostic clarity beyond molecular testing and supporting integration into routine workflows. Trial Registration: The authors have confirmed clinical trial registration is not needed for this submission.
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