Monoclonal pattern of T-Lymphocytes and B-Lymphocytes receptors gene rearrangement in Acute Lymphocytic Leukemia in Basrah

Abstract

Author(s): Nibras S. Al-Ammar*, Hermann Kreyenberg and Mayada T. Abdulrahman

Paediatrics clinicians face a problem in evaluation of chemotherapy treatment used for Acute Lymphoblastic Leukaemia (ALL) patients in Iraq. They need an accurate test to evaluate the treatment. This study aimed to detect the clonality pattern of T and B lymphocytes receptors gene rearrangements in ALL patients in Basrah before chemotherapy. Bone morrow aspiration samples from 50 ALL patients used for DNA extraction followed by multiplex PCR by using 42 primers. A total of 147 bands cut from polyacrylamide gel and sent for sequencing in order to detect the pattern of receptors gene rearrangements. 15th ALL patients were found to have rearrangements in the studied genes coding for receptors of T and B lymphocytes; TCR and Ig. Ten patients have a rearrangement of Ig while 5 patients rearranged TCR. Immunoglobulin Heavy Chain (IGH) gene was rearranged in 6 patients. Some patients appeared to have more than one rearrangement in TCR, IGH, IGK, TCRD and TCRG genes, while the rest of the samples have only one rearrangement. The highest clonality appeared in IGH gene in VH1-7/JH, DH1-6/JH and DH7/JH. Studying Ig and TCR gene rearrangements are an important step for testing MRD which consider now a diagnostic method that evaluate chemotherapy protocol treatment and also predict the patient chance of relapse. The current study might be the first step for further work that can help in chemotherapy treatment evaluation in Iraq.

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