{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:53:06Z","timestamp":1789015986698,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T00:00:00Z","timestamp":1660176000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>T\u2010cell clonality testing by T\u2010cell receptor (TCR) gene rearrangement is key to the diagnosis of T\u2010cell lymphoproliferative disorders such as T\u2010cell large granular lymphocytic (T\u2010LGL) leukemia. Benign clonal T\u2010cell expansions, however, are commonly found in patients without identifiable disease, a condition referred to as T\u2010cell clones of uncertain significance (T\u2010CUS). In practice, T\u2010cell clonality testing is performed for a range of reasons and results are often challenging to interpret given the overlap between benign and malignant clonal T\u2010cell proliferations and uncertainties in the management of T\u2010CUS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a 5\u2010year retrospective cohort study of 211 consecutive patients who underwent PCR\u2010based T\u2010cell clonality testing for suspected T\u2010LGL leukemia at our institution to characterize the use of T\u2010cell clonality testing and its impact on patient management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 46.4% (<jats:italic>n<\/jats:italic>\u00a0=\u00a098) of individuals tested had a clonal T\u2010cell population identified. Patients with a monoclonal T\u2010cell population were more likely to be older, have rheumatoid arthritis and have higher lymphocyte counts compared to patients with polyclonal populations. The majority of patients eventually diagnosed and treated for T\u2010LGL leukemia had rheumatoid arthritis and lower neutrophil counts compared to untreated patients with monoclonal T\u2010cell populations. A diagnosis of T\u2010LGL leukemia was made in only a minority of patients (<jats:italic>n<\/jats:italic>\u00a0=\u00a048, 22.7%), and only a small proportion were treated (<jats:italic>n<\/jats:italic>\u00a0=\u00a017, 8.1%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study suggests that T\u2010cell clonality testing most commonly identifies incidental T\u2010cell clones with only a minority of patients receiving a diagnosis of T\u2010LGL leukemia and fewer requiring active treatment. These finding indicate an opportunity to improve utilization of T\u2010cell clonality testing in clinical practice to better target patients where the results of testing would impact clinical management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijlh.13949","type":"journal-article","created":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T11:17:07Z","timestamp":1660216627000},"page":"1115-1120","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["T\u2010cell clonality testing for the diagnosis of T\u2010cell large granular lymphocytic leukemia: Are we identifying pathology or incidental clones?"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0737-3603","authenticated-orcid":false,"given":"Benjamin","family":"Chin\u2010Yee","sequence":"first","affiliation":[{"name":"Division of Hematology, Department of Medicine, Schulich School of Medicine and Dentistry Western University  London 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