Original Articles
Vol. 17 No. 1 (2025): Review Articles, Original Article, Scientific Letter, Case Reports Letter to the Editor
T-CELL RECEPTOR (TCR)-VΒ REPERTOIRE FLOW CYTOMETRY FOR T-CELL LYMPHOPROLIFERATIVE DISORDER: A RETROSPECTIVE ANALYSIS OF A SINGLE-CENTER REAL-LIFE LABORATORY EXPERIENCE
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Received: December 17, 2024
Accepted: February 5, 2025
Accepted: February 5, 2025
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Background: Discrimination between clonal and reactive cell proliferation is critical for the correct management of T-cell lymphocytosis. Multiparametric flow cytometry (MFC) represents a valuable tool, particularly because it allows to evaluate the T-cell receptor (TCR) Vβ repertoire to pinpoint eventual clonality in T-cell lymphocytosis. A restricted expansion of a single out of the 24 evaluable families or a “clonogram-off” pattern are highly suggestive of the presence of a clonal T-cell population. However, data available on the concordance between MFC TCR-Vβ repertoire and molecular analysis of TCR gene rearrangements, which is regarded as the gold standard for assessing T-cell clonality, are limited.
Objective and methods: We performed a retrospective monocentric study including 307 patients referred to our center for lymphocytosis between 2003 and 2024. The aim of our study was to investigate the diagnostic accuracy of MFC TCR-Vβ repertoire analysis and to compare its performance with molecular analysis of TCR gene rearrangements, for the identification of T-cell clonality.
Results: MFC TCR-Vβ repertoire analysis demonstrated a restricted expansion of a single Vβ family in 67.5% of cases, while clonality in the remaining 32.5% was inferred by a “clonogram-off” pattern. For 215 (70%) patients both MFC TCR-Vβ repertoire analysis and molecular analysis of TCR gene rearrangements were available, showing an absolute concordance (215 out of 215 cases, 100%) between the two methods.
Conclusion: MFC TCR-Vβ repertoire analysis is a rapid, cheap, sensitive, and reliable tool to identify clonal T-cell lymphocytosis. It represents an absolute valid first-line diagnostic approach, and it should be included into the routinely laboratory work-up performed MFC analysis for peripheral lymphocytosis.
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Multiparameter flow cytometry (MFC), Hematological malignanciesHow to Cite
“T-CELL RECEPTOR (TCR)-VΒ REPERTOIRE FLOW CYTOMETRY FOR T-CELL LYMPHOPROLIFERATIVE DISORDER: A RETROSPECTIVE ANALYSIS OF A SINGLE-CENTER REAL-LIFE LABORATORY EXPERIENCE” (2025) Mediterranean Journal of Hematology and Infectious Diseases, 17(1), p. e2025016. doi:10.4084/MJHID.2025.016.
Copyright (c) 2025 Marco Antonacci, Jacopo Micozzi, Alessandro Costa, Alessandro Laganà, Maria Laura Milani, Stefania Intoppa, Vittorio Bellomarino, Maria Grazia Nardacci, Mario Biglietto, Stefano Imperatore, Maria Laura Bisegna, Maurizio Martelli, Irene Della Starza, Maria Stefania De Propris
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