Pattern of T-cell receptor delta gene rearrangement by Southern blotting and polymerase chain reaction technique in Hong Kong Chinese patients with non-T-cell hematological malignancies.

摘要

It has been recognized that clonal T-cell receptor delta (TCR delta) gene rearrangement is present in both T-and B-cell malignancies. The highly sensitive polymerase chain reaction (PCR) technique may be applicable to cases of leukemia and lymphoma of non-T-cell origin for detection of minimal residual disease (MRD). A PCR technique was used in this study to investigate the pattern of clonal TCR delta gene rearrangement in Hong Kong Chinese patients with non-T-cell hematological malignancies. Seventy-three patients with the diagnosis of acute leukemia and non-Hodgkin's lymphoma of non-T-cell origin were included in this study. There were 20 patients with common ALL (cALL), seven precursal B-cell ALL (PreB-ALL), 23 acute myeloid leukemia (AML), and 23 non-Hodgkin's lymphoma of B-lineage (B-NHL). Clonal rearrangement was detectable by Southern analysis using a J delta 1 probe in 41 per cent of ALL of B-lineage but in none of the B-NHL or AML. The samples were also studied further by monoclonal PCR amplification for TCR delta gene rearrangement. Three different sets of primers were employed to detect clonal rearrangement of the TCR delta gene. The V delta 1(D)J delta 1 recombination typically seen in T-cell malignancies were not seen in any of the of the non-T-cell malignancies. The V delta 2 (D) D delta 3 recombination was found exclusively in ALL of B-lineage and was seen in 73 per cent of the Southern positive cases. Although clonal TCR delta gene rearrangement was undetectable by Southern analysis in our AML cases, 26 per cent had a V delta 2(D)J delta 1 recombination found by the PCR technique. Sensitivity of the PCR technique was determined by serial mixing and was up to 5-10 leukemic cells per 10(4) nucleated cells. It was apparent from this study that it was feasible to detect clonal TCR delta gene rearrangement by the PCR technique in a proportion of the cases of non-T-cell hematological malignancies. The PCR technique can be applied to detect residual leukemic cells in marrow of patients in anapparent morphological complete remission. The value of this application requires further clinical evaluation and correlation.