[Determination of clonal T cell receptor gene rearrangement in non-Hodgkin's lymphoma patients and its clinical significance].

Background & Objective: The aim of this study was to investigate the clonal T cell receptor (TCR) gene rearrangement in the patients with non-Hodgkin's lymphoma (NHL) and its clinical significance.

Methods: TCRVgammaI-Jgamma gene rearrangement were detected in 43 patients with polymerase chain reaction (PCR) and single-strand conformation polymorphism (SSCP).

Results: Of 43 cases of NHL, 26 (60.5%) were found with clonal TCRVgammaI-Jgamma gene rearrangement. Among 16 cases without bone marrow morphologic involvement,3 cases (18.8%) were found with clonal TCRVgammaI-Jgamma gene rearrangement. These 3 cases presented bone marrow morphologic involvement 4-9 months later. Clonal TCRVgammaI-Jgamma gene rearrangement were detected in 85.2%(23/27) cases with bone marrow morphologic involvement. Among 26 cases with clonal TCRVgammaI-Jgamma gene rearrangement, 7 cases (26.9%) was found with oligoclonal/subclonal rearrangement after PCR-SSCP analysis. Of 7 cases with oligoclonal/subclonal rearrangement, 5 (71.4%) developed to leukemia 3-11 months later. The number of NHL patients with oligoclonal/subclonal rearrangement developed to leukemia was significantly higher than that (10.5%) of NHL patients without oligoclonal/subclonal rearrangement (P< 0.005) within 1 year.

Conclusion: The detection of clonal TCRVgammaI-Jgamma gene rearrangement by PCR methods can be used to find bone marrow minimal disease in NHL patients without morphologic abnormality. NHL patients with oligoclonal/subclonal rearrangement are more likely to develop to leukemia; it can also develop to acute nonlymphoblastic leukemia. Further investigation was needed in this respect.