Clearly, the most common cause of false-negative IGH PCR results for BCL is the failure of primer binding due to alteration of the sequence of the region amplified by the primer following somatic hypermutation of IgVH regions in postgerminal center BCL. The false-negative rate with IGH PCR ranges from <5% (MCL) to >50% (MZL, FL, plasma cell dyscrasias). These BCLs that give false-negative results by PCR almost always will have clonal IGH rearrangements by SBA, which is used as a follow-up test for BCL with unexpectedly negative IGH PCR results in some clinical molecular laboratories. The possibility of a false-negative IGH PCR result in these postgerminal center BCLs must always be considered in the interpretation of IGH PCR results.
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