Research ArticleCancer

Minimal Residual Disease Monitoring with High-Throughput Sequencing of T Cell Receptors in Cutaneous T Cell Lymphoma

Science Translational Medicine  04 Dec 2013:
Vol. 5, Issue 214, pp. 214ra171
DOI: 10.1126/scitranslmed.3007420

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Skin Lymphoma HTS the Spot

Mycosis fungoides and Sézary syndrome are two cancers of lymphocytes that arise in the skin. These diseases are not curable with standard therapies; however, they frequently enter into long periods of remission after bone marrow transplantation. Monitoring minimal residual disease (MRD) in these patients is critical for early intervention. Flow cytometry coupled with clonality determination by T cell receptor polymerase chain reaction (PCR) are the current diagnostic criteria; however, these tests lack both specificity and sensitivity. Now, Weng et al. use high-throughput sequencing of T cell receptor B chains to monitor MRD in patients with either mycosis fungoides or Sézary syndrome. They found increased sensitivity and specificity compared with flow cytometry and standard PCR, and could monitor therapy response in these patients. Monitoring MRD and determination of clinically meaningful molecular remission could greatly aid in managing these patients after transplant.