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Updated: Aug 8, 2025

Comparative Lesions Analysis Through a Targeted Sequencing Approach
Published on: November 5, 2019
Read the clonotype: Next-generation sequencing-based lymphocyte clonality analysis and perspectives for application
Patricia J T A Groenen1,2, Michiel van den Brand1,3, Leonie I Kroeze1,2
1Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands.
Insights
Next-generation sequencing (NGS) offers a more sensitive method for detecting immunoglobulin (IG) and T-cell receptor (TR) gene rearrangements. This advanced clonality testing aids in diagnosing lymphomas and other conditions.
Area of Science:
- Hematology
- Molecular Biology
- Oncology
Background:
- Clonality assessment of immunoglobulin (IG) and T-cell receptor (TR) genes is crucial for diagnosing B-cell and T-cell lymphomas.
- Conventional fragment analysis methods for clonality testing have limitations in sensitivity and precision.
Purpose of the Study:
- To develop and validate a next-generation sequencing (NGS)-based clonality assay for IG and TR gene rearrangements.
- To enhance sensitivity and precision in clone detection and comparison compared to traditional methods.
Main Methods:
- Development and validation of an NGS-based assay for IG heavy and kappa light chain, and TR gene rearrangements.
- Application of the assay to formalin-fixed and paraffin-embedded tissues.
Main Results:
- The NGS-based assay provides more sensitive detection of lymphocyte clones.
- It allows for more precise comparison of clones than conventional fragment analysis.
Conclusions:
- NGS-based clonality testing is a powerful tool for diagnosing lymphomas.
- Potential applications include site-specific lymphoproliferations, immunodeficiency, autoimmune diseases, and monitoring primary and relapsed lymphomas.
Abstract:
Clonality assessment using the unique rearrangements of immunoglobulin (IG) and T-cell receptor (TR) genes in lymphocytes is a widely applied supplementary test for the diagnosis of B-cell and T-cell lymphoma. To enable a more sensitive detection and a more precise comparison of clones compared with conventional clonality analysis based on fragment analysis, the EuroClonality NGS Working Group developed and validated a next-generation sequencing (NGS)-based clonality assay for detection of the IG heavy and kappa light chain and TR gene rearrangements for formalin-fixed and paraffin-embedded tissues. We outline the features and advantages of NGS-based clonality detection and discuss potential applications for NGS-based clonality testing in pathology, including site specific lymphoproliferations, immunodeficiency and autoimmune disease and primary and relapsed lymphomas. Also, we briefly discuss the role of T-cell repertoire of reactive lymphocytic infiltrations in solid tumors and B-lymphoma.
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