# Immunoglobulin and T-cell receptor clonality

Source: https://onco.cc/biomarkers/ig-tcr-clonality/  
OnCo record `ig-tcr-clonality` (Biomarker). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A test that asks whether a group of lymphocytes all descend from one cell. Cancer is one family; a normal immune response is a crowd. It is used when the appearance under the microscope does not settle the question.

## Summary

Every lymphocyte rearranges its antigen receptor genes into a sequence unique to itself, so a lymphoma made of one clone gives amplicons of one length and sequence while a reactive population gives a smooth spread.

The European BIOMED-2 collaboration standardised the assay into 107 primers in 18 multiplex tubes covering IGH in two configurations, IGK, IGL, TCRB, TCRG and TCRD plus the BCL1-IGH and BCL2-IGH translocations, with products read by heteroduplex analysis or fragment sizing. The complementarity of the tubes is what makes the detection rate high: combined IGH and IGK tubes detect virtually all clonal B-cell proliferations even where somatic hypermutation is heavy, and combined TCRB and TCRG tubes detect virtually all clonal T-cell populations (van Dongen 2003). The EuroClonality-NGS successor sequences the amplicons rather than sizing them and produces a patient-specific sequence that can be followed afterwards as a residual disease marker.

The result is a pattern, not a diagnosis, and the commonest harm this test does is being read as one.

## Fields

- Kind: Biomarker
- Last checked: 2026-09-30
- Also known as: IGH clonality; TCR clonality; clonal rearrangement; gene rearrangement study; B-cell clonality; T-cell clonality; BIOMED-2
- Tags: biomarker; lymphoma

## Sources

- van Dongen et al., Leukemia 2003: BIOMED-2 multiplex PCR for clonal immunoglobulin and T-cell receptor rearrangements: https://doi.org/10.1038/sj.leu.2403202

## Connected records

- cancers: [Cutaneous T-cell lymphoma (mycosis fungoides and Sezary syndrome)](https://onco.cc/cancers/cutaneous-t-cell-lymphoma/), [Diffuse large B-cell lymphoma](https://onco.cc/cancers/dlbcl/), [Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma)](https://onco.cc/cancers/malt-lymphoma/), [Follicular lymphoma](https://onco.cc/cancers/follicular-lymphoma/), [Marginal zone lymphoma](https://onco.cc/cancers/marginal-zone-lymphoma/), [Nodal T-follicular helper cell lymphoma, angioimmunoblastic type (angioimmunoblastic T-cell lymphoma)](https://onco.cc/cancers/angioimmunoblastic-t-cell-lymphoma/), [Non-Hodgkin lymphoma (all types)](https://onco.cc/cancers/non-hodgkin-lymphoma/), [Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma)](https://onco.cc/cancers/peripheral-t-cell-lymphoma/), [Richter transformation of chronic lymphocytic leukaemia](https://onco.cc/cancers/richter-transformation-cll/), [Sezary syndrome](https://onco.cc/cancers/sezary-syndrome/)
- technologies: [Immunoglobulin and T-cell receptor clonality testing](https://onco.cc/technologies/clonality-testing/), [Multiparameter flow cytometry MRD](https://onco.cc/technologies/flow-cytometry-mrd/), [NGS-based MRD (clonoSEQ and molecular MRD)](https://onco.cc/technologies/ngs-mrd-clonoseq/)
- pathways: [Clonal evolution & minimal residual disease](https://onco.cc/pathways/clonal-evolution/)
- terms: [Minimal / molecular residual disease (MRD)](https://onco.cc/terms/mrd/), [Next-generation sequencing (NGS)](https://onco.cc/terms/ngs/), [The germinal centre: why lymphoma starts where antibodies are made](https://onco.cc/terms/lymphoma-bio-germinal-centre/)

---
JSON: https://onco.cc/api/v1/entities/ig-tcr-clonality.json