{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T16:48:21Z","timestamp":1778777301679,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"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":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Recently, monoclonal antibodies targeting one of the two mutually exclusive constant regions of the TCR \u03b2 receptor chain (TRBC1 and TRBC2) have been proposed as a surrogate tool for assessing T\u2010cell clonality by flowcytometry. The detection of T\u2010cell clones is typically interpreted in the context of malignancy. However, small T\u2010cell clones of uncertain significance (T\u2010CUS) are frequently identified, posing diagnostic and clinical challenges. Since 2022, TRBC1 was incorporated as a marker for T\u2010cell clonality in our flowcytometric lymphoid screening tube (LST), a tube designed to detect both B\u2010 and T\u2010cell aberrancies in the blood of patients with clinical suspicion of hematological malignancy. The objective of the current study was to systematically evaluate the frequency and size of T\u2010cell clones identified at initial diagnosis and to evaluate clonal evolution in follow\u2010up samples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single\u2010centre retrospective study (2022\u20132024), peripheral blood samples of 3495 unique patients were tested for T\u2010cell clonality using TRBC1. The monotypic T\u2010cell clones of &gt;\u200950\/\u03bcL were stratified into three groups: T\u2010CUS1 (50\u2013500\u2009monotypic cells\/\u03bcL), T\u2010CUS2 (500\u20132000\u2009monotypic cells\/\u03bcL), and T\u2010LGL (&gt;\u20092000\u2009monotypic cells\/\u03bcL). Follow\u2010up samples were obtained at least 6\u2009months after initial testing (range: 6\u201330\u2009months) and potential indicators of progression to T\u2010CUS2 or T\u2010LGL were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The majority of T\u2010CUS clones (22\/36, 61%) were not detected (&lt;\u200950\u2009monotypic cells\/\u03bcL) at follow\u2010up, thereby demonstrating the importance of evaluation of the persistance of small T\u2010cell clones. Fifteen percent of patients with a T\u2010CUS1 progressed to T\u2010CUS2, but none to T\u2010LGL (95% CI: 0%\u201315%). 22% (95% CI: 3%\u201360%) of T\u2010CUS2 patients evolved to T\u2010LGL, all of which showed aberrant expression of CD57. In the patient group who showed evolution to T\u2010CUS2 or T\u2010LGL, significantly lower hemoglobin levels and neutrophil counts were observed at the time of T\u2010CUS detection. Additionally, in this group, comparable increases in monotypic T\u2010cell clones were observed over time, with a main increment of 90\u2009monotypic cells\/\u03bcL per month (95% CI: 34%\u2013145%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The low number of persistence observed in T\u2010CUS at follow\u2010up highlights the need for cautious interpretation of small T\u2010cell clones (T\u2010CUS1). Low hemoglobin and neutrophil counts at diagnosis might indicate higher risk for progression and need for closer follow\u2010up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijlh.14525","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T04:03:41Z","timestamp":1751342621000},"page":"1083-1088","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Assessing the Persistence and Relevance of Small T\u2010\n                    <scp>LGL<\/scp>\n                    Clones via\n                    <scp>TRBC1<\/scp>\n                    in a Flowcytometric Lymphoid Screening Tube"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5839-7539","authenticated-orcid":false,"given":"Nathan","family":"Debunne","sequence":"first","affiliation":[{"name":"Laboratory of Hematology AZ Sint\u2010Jan Hospital  Bruges Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2264-7302","authenticated-orcid":false,"given":"Barbara","family":"Cauwelier","sequence":"additional","affiliation":[{"name":"Laboratory of Hematology AZ Sint\u2010Jan Hospital  Bruges Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Devos","sequence":"additional","affiliation":[{"name":"Laboratory of Hematology AZ Sint\u2010Jan Hospital  Bruges Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvia","family":"Snauwaert","sequence":"additional","affiliation":[{"name":"Department of Hematology AZ Sint\u2010Jan Hospital  Bruges Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Emmerechts","sequence":"additional","affiliation":[{"name":"Laboratory of Hematology AZ Sint\u2010Jan Hospital  Bruges Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cyto.b.22147"},{"issue":"1","key":"e_1_2_11_3_1","first-page":"37","article-title":"T\u2010Cell Clones of Uncertain Significance. When Is the Rogue Clone Dangerous?","volume":"110","author":"Semenzato G.","year":"2025","journal-title":"Haematologica"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-020-0568-2"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqaa214"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tranon.2022.101552"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2015.04.030"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2012.120"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22041817"},{"issue":"17","key":"e_1_2_11_10_1","first-page":"1","article-title":"Anti\u2010TRBC1 Antibodybased Flow Cytometric Detection of T\u2010Cell Clonality: Standardization of Sample Preparation and Diagnostic Implementation","volume":"13","author":"Munoz\u2010Garcia N.","year":"2021","journal-title":"Cancer"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2012.122"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.14045"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26010170"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)61377-9"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2021.279140"},{"issue":"1","key":"e_1_2_11_16_1","first-page":"38","article-title":"T\u2010Cell Receptor Gamma Delta\u2010Expressing Intraepithelial Lymphocytes Are Present in Normal and Chronically Inflamed Human Gingiva","volume":"79","author":"Lundqvist C.","year":"1993","journal-title":"Immunology"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1126\/sciimmunol.ade3525"}],"container-title":["International Journal of Laboratory Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijlh.14525","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T03:33:04Z","timestamp":1762745584000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijlh.14525"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":16,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1111\/ijlh.14525"],"URL":"https:\/\/doi.org\/10.1111\/ijlh.14525","archive":["Portico"],"relation":{},"ISSN":["1751-5521","1751-553X"],"issn-type":[{"value":"1751-5521","type":"print"},{"value":"1751-553X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2025-04-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}