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Test Code 5952 T Cell Receptor Gamma (TCRG) Gene Rearrangement

Performing Laboratory

Barnes-Jewish Hospital Laboratory


Extracted genomic DNA is analyzed by a laboratory-developed test using the LymphoTrack® Dx TRG Assay reagents from InVivoScribe Technologies. Massively parallel (“Next-generation”) sequencing of libraries is performed on a Life Technologies Ion Torrent S5™ sequencer. TRG rearrangement sequences are detected and relative proportion determined as a percentage of total sequencing reads using the LymphoTrack® Dx TRG clonality testing software. Limitations: The assay primers cannot detect 100% of possible TRG rearrangements. Low DNA input, DNA degradation, and/or interfering substances may cause failure to detect a TRG rearrangement by this assay.


Literature References

1. Tonegawa S. Somatic generation of antibody diversity. Nature. 1983;302(5909):575-581.

2. Gazzola A, Mannu C, Rossi M, et al. The evolution of clonality testing in the diagnosis and monitoring of hematological malignancies. Therapeutic advances in hematology. 2014;5(2):35-47.

3. Schumacher JA, Duncavage EJ, Mosbruger TL, Szankasi PM, Kelley TW. A comparison of deep sequencing of TCRG rearrangements vs traditional capillary electrophoresis for assessment of clonality in T-cell lymphoproliferative disorders. Am J Clin Pathol. 2014;141(3):348-359.

4. Sufficool KE, Lockwood CM, Abel HJ, et al. T-cell clonality assessment by next-generation sequencing improves detection sensitivity in mycosis fungoides. J Am Acad Dermatol. 2015;73(2):228-236. e2

Specimen Requirements

Call Barnes-Jewish Hospital Molecular Diagnostics Laboratory at 314-454-8685 for collection instructions.
Forms: Molecular Diagnostics Laboratory Request for DNA Studies-Oncology in Special Instructions.
Submit only 1 of the following specimens:
Specimen Type: Blood
Container/Tube: Lavender top (EDTA)
Specimen Volume: Full tube
Specimen Minimum Volume: 1 to 2 mL
Collection Instructions:
1. Invert several times to mix blood.Clotted blood is not acceptable.
2. Specimen cannot be frozen.
Specimen Type: Bone marrow
Container/Tube: Lavender top (EDTA)
Specimen Volume: 1 to 2 mL
Collection Instructions:
1. Invert several times to mix bone marrow. Clotted bone marrow is not acceptable.
2. Specimen cannot be frozen.
Specimen Type: Tissue, formalin-fixed, paraffin-embedded
Container/Tube: Sterile, microcentrifuge tube
Specimen Volume: Twenty, 10-micron sections
Specimen Type: Tissue, fresh
Container/Tube: Sterile, plastic container
Specimen Volume: 10 mm3
Additional Information: Forward frozen tissue on dry ice.

Day(s) Test Set Up

Turnaround Time:
STAT: Director approval required
Routine: 7 to 10 business days

Reference Values

An interpretative report will be provided.

Test Classification and CPT Coding


Additional Information

For BJH Laboratory Use Only

Analyte Stability:
Blood is stable 0 to 4 hours at ambient temperature, 96 hours at 4° C.
FFPE tissue stable indefinitely.
Fresh-frozen tissue is stable at -20° C.


Laboratory Processing Instructions:
Test performed in BJH Molecular Diagnostics.

Specimen Transport Temperature

Ambient/Refrigerate NO/Frozen NO-Blood; Bone Marrow; Tissue, Formalin-Fixed, Paraffin-Embedded
Frozen on Dry Ice-Tissue, Fresh