TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population(s)
CPT4 code
Name of the Procedure:
T Cell Antigen Receptor, Gamma (TRG@) Gene Rearrangement Analysis
Common Name: TRG@ Gene Rearrangement Analysis
Technical Term: T Cell Receptor, Gamma Gene Rearrangement Test
Summary
T cell receptor, gamma (TRG@) gene rearrangement analysis is a laboratory test used to identify abnormal clonal populations of T cells in patients. It evaluates genetic alterations in the T cell receptor, gamma region, which can indicate the presence of certain types of leukemia or lymphoma.
Purpose
This procedure is performed to detect and diagnose abnormal clonal populations of T cells that may signify leukemia or lymphoma. The goal is to identify these malignant cells early to ensure prompt and targeted treatment.
Indications
- Unexplained lymphadenopathy (swollen lymph nodes).
- Persistent or unexplained fever.
- Night sweats and weight loss in the absence of infection.
- Elevated white blood cell count.
- Immunophenotyping indicating T cell abnormalities.
- Monitoring treatment response or disease recurrence in patients with known T cell malignancies.
Preparation
- No specific pre-procedure preparations such as fasting or medication adjustments are typically required for this test.
- A blood or tissue sample will be needed, so the patient may undergo routine blood draw or biopsy.
Procedure Description
- Sample Collection: A blood sample is drawn or a tissue biopsy is performed by a healthcare provider.
- DNA Extraction: DNA is isolated from the collected cells.
- PCR Amplification: Polymerase Chain Reaction (PCR) is used to amplify the DNA segments of the TRG@ gene.
- Gene Analysis: The amplified DNA is analyzed to detect any rearrangements in the TRG@ gene region, indicating clonal T cell populations.
Duration
The entire process from sample collection to result analysis typically takes 1-2 weeks, depending on the laboratory's protocols.
Setting
The procedure takes place in a clinical laboratory. Sample collection can occur in various settings, including hospitals, outpatient clinics, or specialized diagnostic centers.
Personnel
- Phlebotomist (for blood sample collection) or Pathologist (for tissue biopsy).
- Laboratory Technologists (for DNA extraction and amplification).
- Pathologists or Geneticists (for the analysis and interpretation of results).
Risks and Complications
- Blood draw or biopsy: minor risks include bruising, bleeding, or infection at the collection site.
- Laboratory Analysis: no direct risks to patients.
Benefits
- Accurate diagnosis of T cell malignancies such as leukemia and lymphoma.
- Early detection leads to better treatment outcomes.
- Monitoring disease progression or remission.
Recovery
- Blood draw: immediate recovery; bandage at the puncture site, mild soreness.
- Biopsy: minor discomfort, follow post-biopsy care instructions.
- No significant recovery time needed for the analysis itself.
Alternatives
- Flow cytometry: assesses cell populations based on surface markers.
- Bone marrow biopsy: provides a comprehensive view of bone marrow cells.
- These alternatives might complement rather than replace TRG@ gene rearrangement analysis, depending on the diagnosis.
Patient Experience
- During: Blood draw or biopsy may cause mild discomfort.
- After: Blood draw recovery is immediate; biopsy recovery includes minor soreness or bruising.
- Managing pain: Over-the-counter pain relief if necessary, for a biopsy.