Immunoglobulin and T-cell receptor gene rearrangement.

Gene rearrangement involves a complex process of DNA splicing and deletion that produces a unique genetic code in each B or T lymphocyte. These novel DNA sequences encode immunoglobulin or T-cell receptor proteins that function in recognition of foreign antigens. Recent advances in DNA technology permit laboratory detection of clonal gene rearrangements in lymphoid malignancies including lymphocytic leukemia, lymphoma, and myeloma. Practical applications of gene rearrangement testing include distinguishing reactive from malignant lymphoid proliferations, and assignment of B- or T-cell lineage to a neoplastic process. Active investigation is underway to devise practical strategies for detecting minimal residual disease based on tumor-specific gene rearrangements.