Download Minimal residual disease monitoring with high

HEMATOLOGY/ONCOLOGY
CASE STUDY
Minimal residual
disease monitoring
with high-throughput
sequencing of T-cell
receptors in cutaneous
T-cell lymphoma
Weng WK, et al. Sci Transl Med. 2013;5(214):214ra171
DECEMBER 2013
WHY IMMUNOSEQ?
The immunoSEQ Assay allowed
investigators to identify the clonally
expanded population of T cells in
diagnostic samples
MRD could be tracked with higher
sensitivity and specificity than
flow cytometry
CASE STUDY: Minimal residual disease monitoring with high-throughput sequencing of T-cell
receptors in cutaneous T-cell lymphoma—Weng WK, et al. Sci Transl Med. 2013;5(214):214ra171
BACKGROUND
The most common types of cutaneous non-Hodgkin’s lymphoma include mycosis
fungoides (MF) and Sézary syndrome (SS)
AIM
To develop a specific and sensitive tool to monitor minimal residual disease (MRD) in
MF and SS
WHY IMMUNOSEQ?
The immunoSEQ Assay
allowed investigators
to identify the clonally
expanded population of
T cells in diagnostic samples
METHODS
Skin samples and peripheral blood mononuclear cells (PBMCs) were derived from
subjects receiving allogeneic hematopoietic cell transplantation (HCT) in advanced-stage
MF and SS
1
Before allogeneic HCT: Skin or PBMCs  gDNA extraction  immunoSEQ ®
2
Alogeneic HCT
3
90 days: Skin or PBMCs  gDNA extraction  immunoSEQ
4
Additional time points depending on status
MRD could be tracked
with higher sensitivity
and specificity than flow
cytometry
RESULTS
BMT, bone marrow transplant
The immunoSEQ Assay detected Sézary cells in all 10 subjects before HCT, while flow cytometry detected Sézary cells in only four
of the 10 subjects (data not shown)
Five subjects achieved molecular remission’ in blood between +30 and +540 days after HCT (example 2 above). Four of these also
achieved molecular clearance in skin after transplant
CONCLUSIONS
•T
he sensitivity of flow cytometry is inadequate in cases with low tumor burden
• Immunosequencing is both sensitive and specific; therefore, using the immunoSEQ
Assay as a method of MRD detection may lead to earlier intervention
For Research Use Only. Not for use in diagnostic procedures.
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