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Immunoglobulin gene testing for B-cell leukemia |
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Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Immunoglobulin gene testing for B-cell leukemia. Lansdale: HAYES, Inc.. Genetic Testing Publication. 2014 Authors' conclusions Leukemia refers to a group of cancers characterized by abnormal growth of blood cells in the bone marrow. In 2013, it was estimated that there would be 48,610 new cases and 23,720 deaths from leukemia in the United States. The most common type of leukemia is acute lymphoblastic leukemia (ALL). Leukemias are diagnosed based on morphologic and histochemical findings, and immunophenotypic evaluation of protein expression in cells. In addition, evaluation of immunoglobulin (IG) genes may provide further information to aid in diagnosis. These genes are involved in B-cell development whereby a series of rearrangements occurs in IG genes, resulting in a large number of products of multiple sizes (referred to as polyclonality). In cancer, however, an error during recombination may result in a single rearrangement occurring multiple times, leading to the amplification of a single clone (referred to as clonality or monoclonality). Therefore, by analyzing specific regions of the IG genes immunoglobulin heavy locus (IGH) and immunoglobulin kappa locus (IGK), clonality or polyclonality may be evaluated to potentially provide information regarding malignancy and provide supportive evidence for leukemia diagnoses in combination with other criteria (which include clinical and histologic findings). While a large proportion of pediatric patients with ALL are cured after treatment, 15% to 20% of children will experience a relapse. These patients may display minimal residual disease (MRD) whereby a small number of detectable leukemic cells are present among normal cells. Using clonality information from IG and non-IG genes, MRD levels are quantified; studies have shown a statistically significant correlation between MRD positivity and relapse rates. Therefore, evaluation of MRD levels may guide more aggressive treatment in patients showing higher MRD levels. Indexing Status Subject indexing assigned by CRD MeSH Genes, Immunoglobulin; Genetic Testings; Leukemia, Lymphocytic, Chronic, B-Cell Language Published English Country of organisation United States English summary An English language summary is available. Address for correspondence HAYES, Inc., 157 S. Broad Street, Suite 200, Lansdale, PA 19446, USA. Tel: 215 855 0615; Fax: 215 855 5218 Email: hayesinfo@hayesinc.com AccessionNumber 32014000481 Date abstract record published 04/04/2014 |
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