PT  - JOURNAL ARTICLE
AU  - Etienne Mahe
AU  - Tevor Pugh
AU  - Suzanne Kamel-Reid
TI  - T cell clonality assessment: past, present and future
AID  - 10.1136/jclinpath-2017-204761
DP  - 2017 Oct 21
TA  - Journal of Clinical Pathology
PG  - jclinpath-2017-204761
4099  - http://jcp.bmj.com/content/early/2017/10/21/jclinpath-2017-204761.short
4100  - http://jcp.bmj.com/content/early/2017/10/21/jclinpath-2017-204761.full
AB  - T cell clonality testing has important clinical and research value, providing a specific and reproducible assessment of clonal diversity in T cell proliferations. Here we review the conceptual foundations of T cell clonality assays, including T cell ontogeny and T cell receptor structure and function; we also provide an introduction to T cell receptor genomics and the concept of the T cell clonotype. This is followed by a review of historical and current methods by which T cell clonality may be assayed, including current assay limitations. Some of these assay limitations have been overcome by employing next-generation sequencing (NGS)-based technologies that are becoming a mainstay of modern molecular pathology. In this vein, we provide an introduction to NGS technologies, including a review of the preanalytical, analytical and postanalytical technologies relevant to T cell clonality NGS assays.