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Updated: Mar 26, 2026

VDJ-Seq: Deep Sequencing Analysis of Rearranged Immunoglobulin Heavy Chain Gene to Reveal Clonal Evolution Patterns of B Cell Lymphoma
Published on: December 28, 2015
Clonal relationships in recurrent B-cell lymphomas
Seung Eun Lee1, So Young Kang2, Hae Yong Yoo3
1Department of Pathology, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Korea.
Insights
Relapse in B-cell lymphomas can originate from an unrelated clone, though uncommon. Sequencing immunoglobulin (Ig) genes, not just PCR fragment size, is crucial for determining clonal relationships between primary and relapsed tumors.
Area of Science:
- Hematology
- Oncology
- Molecular Biology
Background:
- Immunoglobulin (Ig) gene rearrangements are typically stable during neoplastic cell clonal expansion.
- Understanding clonal relationships in lymphoma relapse is critical for accurate diagnosis and treatment.
Purpose of the Study:
- To investigate clonal relationships between primary B-cell lymphomas and their relapsed counterparts.
- To evaluate the reliability of different molecular methods for assessing clonal origin in lymphoma relapse.
Main Methods:
- Analysis of Ig gene rearrangements in 27 paired primary and relapsed lymphoma tissues using BIOMED-2 multiplex PCR.
- Cloning and sequencing of amplified Ig genes in 17 patients to confirm VDJ rearrangements.
- Comparison of fragment lengths and DNA sequences to establish clonal identity.
Main Results:
- All 27 cases showed monoclonal Ig gene rearrangements by PCR.
- Fragment length analysis was discordant in 70% of cases, while sequencing confirmed identical VDJ rearrangements in 77% of cases with differing fragment lengths.
- Unrelated relapses occurred in a minority of cases, were associated with longer disease-free intervals, and tended towards poorer outcomes.
Conclusions:
- Relapse from an unrelated clone is an uncommon but significant event in B-cell lymphomas.
- Sequencing of Ig gene rearrangements provides a more definitive assessment of clonal relationships than PCR fragment size alone.
- Accurate determination of clonal origin is essential for understanding lymphoma behavior and patient outcomes.
Abstract:
Immunoglobulin (Ig) gene rearrangements remain largely unmodified during the clonal expansion of neoplastic cells. We investigated the clonal relationships between lymphoma components at diagnosis and at relapse by analyzing Ig gene rearrangements. A BIOMED-2 multiplex polymerase chain reaction (PCR) assay was performed in 27 patients using formalin-fixed paraffin embedded tissues, with subsequent cloning and sequencing of the amplified Ig genes in 17 patients. All 27 cases of primary and corresponding relapsed tumors showed monoclonal rearrangements of the Ig genes by BIOMED-2 PCR. Whereas IgVH or IgVK fragment lengths were identical in 8/27 pairs (30%), fragment lengths differed in 19/27 pairs (70%). In 17 cases analyzed by sequencing, an identical VDJ gene rearrangement was confirmed in 4/4 pairs (100%) with the same fragment lengths and in 10/13 pairs (77%) with different fragment lengths. Four of 17 primary lymphomas had multiple VDJ rearrangements, and three of them showed an unrelated relapse. Unrelated relapse was observed in 1/8 mantle cell lymphomas, 1/5 diffuse large B-cell lymphomas, and a large B cell lymphoma developed in a patient with a small lymphocytic lymphoma. Unrelated relapses developed after a longer disease-free interval and tended to show poorer outcome compared with related relapse. In summary, relapse of a lymphoma from an unrelated clone is uncommon, but can occur in B-cell lymphomas. Clonal relationships should be determined by sequencing of the Ig genes, and not just by comparing the PCR product size.
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