Immunoglobulin and T-Cell Receptor (Ig/TCR) Gene Rearrangements in Chinese Adult Acute Lymphoblastic Leukemia Patients.

To determine the feasibility of Ig/TCR gene rearrangements as patient-specific targets for the detection of minimal residual disease in Chinese ALL patients, forty adult patients with B-lineage and T cell acute lymphoblastic leukemia(ALL) were enrolled in this study. The frequency and pattern of IGH, IGK, TCRB, TCRG and TCRD gene rearrangement were analyzed by BIOMED-2 multiplex PCR protocol. All DNA samples were obtained from the bone marrow of these patients. IGH, IGK, TCRB, TCRG and TCRD rearrangements were found in 86%,14%,27%,77%,59% of adult patients with B-lineage ALL, respectively. While in T-ALL, clonal TCRB, TCRG and TCRD rearrangements were detected in 83%,78%,39% of patients. There are several features in the pattern of Ig/TCR gene rearrangements in Chinese adult ALL patients. Firstly, IGK rearrangement in adult B-lineage ALL had a lower frequency than in children’s pre-B-ALL (14% vs 41%) in reported literature. Secondly, the frequency of TCRG Vrfl-Jr1.3, Vrfl-Jr1.1 and Vr9-Jr1.3 rearrangement was 65%,6%,29% in adult patients with B-lineage ALL, while 60%,27%,13% was the frequency of those in T-ALL, respectively. In conclusion, our data have shown that several special patterns in Ig/TCR gene rearrangements in Chinese adult ALL patients, may provide a guidance for individual treatment protocol designation and MRD-based risk stratification.