T Cell Clonality by PCR

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General Information

Lab Name
T Cell Clonality by PCR
Lab Code
TCRG
Epic Name
T Cell Clonality Analysis by PCR
Description

Monoclonal populations of T lymphocytes can be identified by testing for T cell receptor gamma chain (TCRG) gene rearrangements using a multiplex polymerase chain reaction assay followed by fragment analysis by capillary electrophoresis. A polyclonal T cell population will produce a Gaussian distribution of PCR products on capillary electrophoresis, while a clonal process will produce one or two discrete peaks.

Sensitivity: This assay detects approximately 95% of T cell clones, provided that the clonal population represents at least 2-5% of the T cells in a specimen.

Hematopathology test request form found at Request Form

Synonyms
Gamma chain, T Cell Receptor
Components
Code Name
TCELSD T Cell Clonality PCR Specimen
TCELRS T Cell Clonality PCR Result
TCELIN T Cell Clonality PCR Interp
TCREV T Cell Clonality Results Reviewed by:
TCELM T Cell Clonality PCR Method
TCRGRN T Cell Clonality Case Number

Interpretation

Guidelines
Method

Polymerase Chain Reaction (PCR)/Capillary Electrophoresis

Reference Range
See individual components

Ordering & Collection

Specimen Type
Blood, Bone Marrow, Tissue - Fresh, frozen or FFPE/PET (Blocks), Fluids, Slides, Sorted Cells
Collection

Preferred:
Blood: 6mL in Lavender Top (EDTA)

Bone Marrow: 1-2mL in Lavender Top (EDTA)

Tissue, Fluids or Sorted cells: Sterile container in RPMI

Formalin-fixed paraffin embedded tissue (FFPE/PET) block

Slides: 10 unstained

Accepted:
Green Tops (Heparin), while green tops are accepted for testing, there is documentation that heparin can interfere with some PCR assays.

Extracted DNA from CLIA certified laboratory.

Formalin-fixed paraffin embedded tissue (FFPE/PET)

Tissue from curls cut from FFPE/PET blocks or stained cover-slipped slides


Unacceptable:
Specimens received beyond stability limit.
Specimens with low volume or inadequate WBC
Decalcified or unacceptable fixatives

Handling Instructions
  • Deliver samples to Hematopathology as soon as possible.
  • If sample is older than 48 hours, please store at 2-6°C upon receipt and send refrigerated.
  • Samples stored at room temperature or refrigerated older than 7 days will be rejected.
  • Frozen samples should be shipped on dry ice.
Quantity
Requested: Blood: 6mL EDTA/BMA: 1-2mL EDTA/Tissue Blocks: Adequate size to cut 10-20 curls/Slides: 10 unstained
Minimum: Blood: 1mL EDTA/ BMA: 0.5mL EDTA/Tissue Blocks: 5 curls/Slides: 5 slides

Processing

Receiving Instructions

Send specimens to Hematopathology – Molecular department for processing.
The stability limit for Blood and Bone Marrow is 7 days, samples beyond this limit will be rejected.

Blood and BMA must arrive in lab by 7am and tissue by 12pm Friday to be included on Tuesday run.

Misc Sendout

Performance

Lab Department
Molecular Hematopathology(MHP)
Frequency
Tuesday and Thursday: Results available up to 5 days.
Available STAT?
No
Performing Location(s)
Other Hematopathology, Molecular
206-606-7060

UW Hematopathology Laboratory, G7-800
Fred Hutchinson Cancer Center
825 Eastlake Avenue E.
Seattle, WA 98109

Hematopathology, Molecular hours:
7:00 am - 5:30 pm M-F
8:00 am - 4:30 pm Saturday, closed on Sunday, and with reduced staffing on major holidays

Billing & Coding

CPT Codes
81342
LOINC
21753-9
Interfaced Order Code
UOW2780