T cell receptor gamma (TCRG) gene rearrangements in T cell acute lymphoblastic leukemia refelct 'end-stage' recombinations: implications for minimal residual disease monitoring

Leukemia. 2000 Jul;14(7):1208-14. doi: 10.1038/sj.leu.2401765.

Abstract

The T cell receptor gamma (TCRG) gene configuration was established in a large series of 126 T cell acute lymphoblastic leukemia (T-ALL) patients using combined Southern blotting (SB) and heteroduplex PCR analyses. The vast majority of TALL (96%) displayed clonal TCRG gene rearrangements, with biallelic recombination in 91% of patients. A small immature subgroup of CD3- T-ALL (n = 5) had both TCRG genes in germline configuration, three of them having also germline TCRD genes. In five patients (4%) combined SB and PCR results indicated oligoclonality. In five rearrangements detected by SB, the Vgamma gene segment could not be identified suggesting illegitimate recombination. Altogether, 83% of TCRG gene rearrangements involved either the most upstream Vgamma2 gene (including four cases with interstitial deletion of 170 bp in Vgamma2) and/or the most downstream Jgamma2.3 segment, which can be perceived as 'end-stage' recombinations. Comparative analysis of the TCRG gene configuration in the major immunophenotypic subgroups indicated that TCRgammadelta+ T-ALL display a less mature immunogenotype as compared to TCRalphabeta+ and most CD3- cases. This was reflected by a significantly increased usage of the more downstream Vgamma genes and the upstream Jgamma1 segments. Comparison between adult and pediatric T-ALL patients did not show any obvious differences in TCRG gene configuration. The high frequency, easy detectability, rare oligoclonality, and frequent 'end-stage' recombinations make TCRG gene rearrangements principal targets for PCR-based detection of minimal residual disease (MRD) in T-ALL. We propose a simple heteroduplex PCR strategy, applying five primer combinations, which results in the detection of approximately 95% of all clonal TCRG gene rearrangements in T-ALL. This approach enables identification of at least one TCRG target for MRD monitoring in 95% of patients, and even two targets in 84% of T-ALL.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alleles
  • Blotting, Southern
  • Child
  • Clone Cells / chemistry
  • Clone Cells / pathology
  • DNA, Neoplasm / genetics
  • Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor*
  • Heteroduplex Analysis
  • Humans
  • Immunophenotyping
  • Leukemia-Lymphoma, Adult T-Cell / genetics*
  • Leukemia-Lymphoma, Adult T-Cell / pathology
  • Neoplasm Proteins / genetics*
  • Neoplasm, Residual
  • Neoplastic Stem Cells / chemistry
  • Neoplastic Stem Cells / pathology
  • Polymerase Chain Reaction
  • Receptors, Antigen, T-Cell, gamma-delta / genetics*
  • Recombination, Genetic*
  • T-Lymphocyte Subsets / chemistry
  • T-Lymphocyte Subsets / pathology

Substances

  • DNA, Neoplasm
  • Neoplasm Proteins
  • Receptors, Antigen, T-Cell, gamma-delta