B- and T-cell gene rearrangement test: an overview of application and methodology.

OBJECTIVE

To examine the use of the B- and T-cell rearrangement test in the diagnosis of lymphoid neoplasms.

DATA SOURCES: Recent texts, professional journals, and authors' experiences.

STUDY SELECTION: Not specified.

DATA EXTRACTION: Not specified.

DATA SYNTHESIS: The B- and T-cell rearrangement test can detect a monoclonal population of B- and T-cells, strongly indicative of neoplasia. This is accomplished through the use of DNA probes. The presence of a unique band on the Southern blot signifies a monoclonal gene rearrangement, which can make or confirm a diagnosis of a lymphoproliferative disorder and classify the lineage as B- or T-cell. T-cell neoplasms generally behave more aggressively than B-cell neoplasms, which can have important implications for prognosis and therapy. The unique gene rearrangement "signature" can be followed during and after therapy to document remission or recurrence. The most commonly examined samples are from the blood, bone marrow, and lymph nodes, but any tissue or fluid suspected of harboring a lymphoid neoplasm can be examined.

CONCLUSION

The test is an important diagnostic indicator in the evaluation and follow-up of patients with lymphoma or lymphoid leukemia. It is most helpful when it can be correlated to the clinical condition of the patient and other ancillary studies.