ArticleMediterranean journal of hematology and infectious diseases2025
T-cell Receptor (TCR)-Vβ Repertoire Flow Cytometry for T-cell Lymphoproliferative Disorder: a Retrospective Analysis of a Single-Center Real-Life Laboratory Experience.
Article in Mediterranean journal of hematology and infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Discrimination between clonal and reactive cell proliferation is critical for the correct management of T-cell lymphocytosis. Multiparametric flow cytometry (MFC) represents a valuable tool, particularly because it allows the evaluation of the T-cell receptor (TCR) Vβ repertoire to pinpoint eventual clonality in T-cell lymphocytosis. A restricted expansion of a single out of the 24 evaluable families or a "clonogram-off" pattern is highly suggestive of the presence of a clonal T-cell population. However, data available on the concordance between MFC TCR-Vβ repertoire and molecular analysis of TCR gene rearrangements, which is regarded as the gold standard for assessing T-cell clonality, are limited. Objective and methods: We performed a retrospective monocentric study involving 307 patients referred to our center for lymphocytosis between 2003 and 2024. The aim of our study was to investigate the diagnostic accuracy of MFC TCR-Vβ repertoire analysis and compare its performance with molecular analysis of TCR gene rearrangements for the identification of T-cell clonality. Results: In clonally restricted cases, MFC TCR-Vβ repertoire analysis demonstrated a restricted expansion of a single Vβ family in 67.5% of cases, while a "clonogram-off" pattern inferred clonality in the remaining 32.5%. For 215 (70%) patients, both MFC TCR-Vβ repertoire analysis and molecular analysis of TCR gene rearrangements were available, showing an absolute concordance (215 out of 215 cases, 100%) between the two methods. Conclusion: MFC TCR-Vβ repertoire analysis is a rapid, cheap, sensitive, and reliable tool to identify clonal T-cell lymphocytosis. It represents an absolutely valid first-line diagnostic approach, and it should be included in the routine laboratory work-up performed on MFC analysis for peripheral lymphocytosis.
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