PCR Detection of Clonality

Monoclonality in ALL is detected by PCR amplification of the IG and/or TCR VDJ region using consensus primers most often to conserved sequences within the framework region of the V region and the D and J regions (Figure 31-

2). The VDJ region varies in size and sequence across a population of B or T cells and allows for detection of a monoclonal leukemic cell population by PCR amplification of a unique PCR product specific to the leukemic clone. For a population of nonlymphoid cells, where the IG and TCR genes are in the germline configuration, amplification will not occur, due to the great distance between the closest V and J regions.10,12,17,20

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