CDR3 size analysis of T cell receptor V beta transcripts: follow-up study in a patient with T cell acute...

T cell acute lymphoblastic leukemia (T-ALL) is generally considered to be a clonal disorder arising as an expansion of committed lymphoid precursors. The generation of functional T cell receptor (TCR) genes involves DNA rearrangement processes. This predisposes immature lymphoid cells to abnormal rearrangements. Previous analysis of the TCR genes strongly suggested the clonal origin of human T-ALL. We present a sensitive clonal analysis of bone marrow TCR V beta transcripts in a case of T-ALL. This study allows the analysis not only of TCR V beta transcripts in tumor cells but also the temporal modification of the global TCR repertoire in the follow-up of clinical specimens from bone marrow aspirates. Moreover, we used clone-specific junctional region oligonucleotide probes corresponding to the clonal leukemic population for the molecular monitoring of the malignant clone throughout the clinical course of the disease. This molecular fingerprint appears to be a sensitive method to detect minimal residual disease. It shows that junctional regions of rearranged TCR beta genes corresponding to the tumor cells can also be detected at the time of the complete remission.