{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T09:13:06Z","timestamp":1775725986361,"version":"3.50.1"},"reference-count":55,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health, Ricerca Corrente Funds","award":["L2\/82-25"],"award-info":[{"award-number":["L2\/82-25"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Nodal marginal zone lymphoma (NMZL) is an indolent B-cell lymphoma that may pose diagnostic challenges due to the absence of distinct markers. In rare atypical cases, an overabundance of PD1+ T follicular helper (TFH) cells in tumor tissue may mimic peripheral T-cell lymphoma (PTCL) of TFH origin, further complicating the diagnosis. A 72-year-old woman with progressive lymphadenopathy had a cervical lymph node biopsy showing a disrupted architecture with monomorphic nodules of CD20+\/MNDA+ B-cells and a prominent central population of proliferating CD4+\/PD1+ T-cells, initially suggestive of a PTCL-TFH. The bone marrow contained aggregates of CD20+ B-cells intermixed with CD3+\/CD4+\/PD1+ T-cells. Next-generation sequencing (NGS) revealed clonal immunoglobulin heavy-chain rearrangements in the lymph node and bone marrow, with T-cell receptor genes displaying a polyclonal pattern. Targeted NGS showed no PTCL-related alterations but identified NMZL-associated mutations with different distributions across lymph node and bone marrow compartments. NOTCH2 mutations (c.6418C&gt;T; p.Gln2140*) were found in both tissues, while the (c.69+2T&gt;A; p.?) TNFRSF14 gene mutation was only detected in the lymph node. The KMT2D gene displayed a frameshift variant in the lymph node (c.4801_4802delinsT; p.Arg1601Leufs*3) and an in-frame deletion (c.11756_11758del; p.Gln3919del) in the bone marrow. Notably, NGS and digital droplet PCR confirmed a TP53 frameshift mutation (c.902del; p.Pro301Glnfs*44) with a fractional abundance of 0.31% in the lymph node and a (c.742C&gt;T; p.Arg248Trp) mutation (0.309%) in the bone marrow. Results underscore the importance of NGS-based clonality to diagnose NMZL with prominent PD1+ T-cell hyperplasia, and prompt further investigation into tissue-specific mutational signatures in these unusual cases.<\/jats:p>","DOI":"10.3390\/ijms27010051","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T14:27:47Z","timestamp":1766500067000},"page":"51","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Nodal Marginal Zone Lymphoma with Prominent Expansion of PD-1+ T-Follicular Helper Cells: A Persistent Diagnostic Challenge with a Heterogeneous Mutational Architecture"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0567-2709","authenticated-orcid":false,"given":"Stefania","family":"Crisci","sequence":"first","affiliation":[{"name":"Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori-IRCCS-Fondazione \u2018G. Pascale\u2019, Via Mariano Semmola 49, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annarosaria","family":"De Chiara","sequence":"additional","affiliation":[{"name":"Pathology Unit, Istituto Nazionale Tumori-IRCCS-Fondazione \u2018G. Pascale\u2019, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7445-1388","authenticated-orcid":false,"given":"Maria","family":"Oro","sequence":"additional","affiliation":[{"name":"Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori-IRCCS-Fondazione \u2018G. Pascale\u2019, Via Mariano Semmola 49, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0333-9758","authenticated-orcid":false,"given":"Maria","family":"Rivieccio","sequence":"additional","affiliation":[{"name":"Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori-IRCCS-Fondazione \u2018G. Pascale\u2019, Via Mariano Semmola 49, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annalisa","family":"Altobelli","sequence":"additional","affiliation":[{"name":"Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori-IRCCS-Fondazione \u2018G. 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Pascale\u2019, Via Mariano Semmola 49, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9805-7846","authenticated-orcid":false,"given":"Daniela","family":"Donnarumma","sequence":"additional","affiliation":[{"name":"Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori-IRCCS-Fondazione \u2018G. Pascale\u2019, Via Mariano Semmola 49, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5590-4714","authenticated-orcid":false,"given":"Matteo","family":"Bonanni","sequence":"additional","affiliation":[{"name":"Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori-IRCCS-Fondazione \u2018G. Pascale\u2019, Via Mariano Semmola 49, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0237-1839","authenticated-orcid":false,"given":"Annarosa","family":"Cuccaro","sequence":"additional","affiliation":[{"name":"Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori-IRCCS-Fondazione \u2018G. Pascale\u2019, Via Mariano Semmola 49, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8084-9009","authenticated-orcid":false,"given":"Alberto","family":"Fresa","sequence":"additional","affiliation":[{"name":"Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori-IRCCS-Fondazione \u2018G. 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Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"blood.2024028268","DOI":"10.1182\/blood.2024028268","article-title":"The Biology of MZL subtypes: Challenge and Relevance of Classification","volume":"30","author":"Laurent","year":"2025","journal-title":"Blood"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1720","DOI":"10.1038\/s41375-022-01620-2","article-title":"The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms","volume":"36","author":"Alaggio","year":"2022","journal-title":"Leukemia"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1182\/blood.2022015851","article-title":"The International Consensus Classification of Mature Lymphoid Neoplasms: A report from the Clinical Advisory Committee","volume":"140","author":"Campo","year":"2022","journal-title":"Blood"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1038\/s41375-022-01764-1","article-title":"A comparison of the International Consensus and 5th World Health Organization classifications of mature B-cell lymphomas","volume":"37","author":"Falini","year":"2023","journal-title":"Leukemia"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e70079","DOI":"10.1002\/hon.70079","article-title":"Marginal Zone Lymphoma: Treatment Update with a Focus on Systemic Approaches","volume":"43","author":"Smith","year":"2025","journal-title":"Hematol. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1056\/NEJMra2102568","article-title":"Marginal-Zone Lymphomas","volume":"386","author":"Rossi","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"35","DOI":"10.3324\/haematol.2021.278755","article-title":"Marginal zone lymphoma: Present status and future perspectives","volume":"107","author":"Cheah","year":"2022","journal-title":"Haematologica"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"4211","DOI":"10.1007\/s00277-024-05688-x","article-title":"Transformation risk and associated survival outcome of marginal zone lymphoma: A nationwide study","volume":"103","author":"Sun","year":"2024","journal-title":"Ann. Hematol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1111\/bjh.14228","article-title":"Dual institution experience of nodal marginal zone lymphoma reveals excellent long-term outcomes in the rituximab era","volume":"175","author":"Starr","year":"2016","journal-title":"Br. J. Haematol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"102592","DOI":"10.1016\/j.eclinm.2024.102592","article-title":"Marginal zone lymphoma international prognostic index: A unifying prognostic index for marginal zone lymphomas requiring systemic treatment","volume":"72","author":"Arcaini","year":"2024","journal-title":"EClinicalMedicine"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"100919","DOI":"10.1016\/j.modpat.2025.100919","article-title":"CD180 as a Robust Immunophenotypic Marker for Differentiating Lymphoplasmacytic Lymphoma\/Waldenstr\u00f6m Macroglobulinemia From Marginal Zone Lymphoma","volume":"38","author":"Guo","year":"2025","journal-title":"Mod. Pathol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1097\/00000478-199901000-00006","article-title":"Primary nodal marginal zone lymphomas of splenic and MALT type","volume":"23","author":"Campo","year":"1999","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1111\/his.12160","article-title":"Nodal reactive and neoplastic proliferation of monocytoid and marginal zone B cells: An immunoarchitectural and molecular study highlighting the relevance of IRTA1 and T-bet as positive markers","volume":"63","author":"Bob","year":"2013","journal-title":"Histopathology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1097\/01.pas.0000209855.28282.ce","article-title":"Programmed death-1 (PD-1) is a marker of germinal center-associated T cells and angioimmunoblastic T-cell lymphoma","volume":"30","author":"Dorfman","year":"2006","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e361","DOI":"10.3324\/haematol.2015.126300","article-title":"Angioimmunoblastic T-cell lymphoma is the most common T-cell lymphoma in two distinct French information data sets","volume":"100","author":"Parrens","year":"2015","journal-title":"Haematologica"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1097\/PAS.0000000000001414","article-title":"Expansion of PD1-positive T Cells in Nodal Marginal Zone Lymphoma: A Potential Diagnostic Pitfall","volume":"44","author":"Egan","year":"2020","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1186\/s13000-023-01422-9","article-title":"Recognizing puzzling PD1\u2009+\u2009infiltrates in marginal zone lymphoma by integrating clonal and mutational findings: Pitfalls in both nodal and transformed splenic cases","volume":"18","author":"Deng","year":"2023","journal-title":"Diagn. Pathol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s00428-023-03633-3","article-title":"The many faces of nodal and splenic marginal zone lymphomas. A report of the 2022 EA4HP\/SH lymphoma workshop","volume":"483","author":"Climent","year":"2023","journal-title":"Virchows Arch."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1093\/ajcp\/aqaa249","article-title":"Markers of Follicular Helper T Cells Are Occasionally Expressed in T-Cell or Histiocyte-Rich Large B-Cell Lymphoma, Classic Hodgkin Lymphoma, and Atypical Paracortical HyperplasiaA Diagnostic Pitfall For T-Cell Lymphomas of T Follicular Helper Origin","volume":"156","author":"Abukhiran","year":"2021","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1097\/PAS.0000000000001515","article-title":"Mutational Analysis Reinforces the Diagnosis of Nodal Marginal Zone Lymphoma With Robust PD1-positive T-Cell Hyperplasia","volume":"45","author":"Hurwitz","year":"2021","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1038\/leu.2012.246","article-title":"EuroClonality\/BIOMED-2 guidelines for interpretation and reporting of Ig\/TCR clonality testing in suspected lymphoproliferations","volume":"26","author":"Langerak","year":"2012","journal-title":"Leukemia"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1002\/ajh.27058","article-title":"Marginal zone lymphoma: 2023 update on diagnosis and management","volume":"98","author":"Cheah","year":"2023","journal-title":"Am. J. Hematol."},{"key":"ref_24","first-page":"282","article-title":"Management of T-cell malignancies: Bench-to-bedside targeting of epigenetic biology","volume":"75","author":"Sabzevari","year":"2025","journal-title":"CA Cancer J. Clin."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1007\/s00428-025-04168-5","article-title":"Exploring the boundaries between neoplastic and reactive lymphoproliferations: Lymphoid neoplasms with indolent behavior and clonal lymphoproliferations-a report of the 2024 EA4HP\/SH lymphoma workshop","volume":"487","author":"Anagnostopoulos","year":"2025","journal-title":"Virchows Arch."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1038\/modpathol.3880541","article-title":"Peripheral T-cell lymphoma mimicking marginal zone B-cell lymphoma","volume":"15","author":"Uherova","year":"2002","journal-title":"Mod. Pathol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3227","DOI":"10.3324\/haematol.2023.282716","article-title":"Pathobiology of nodal peripheral T-cell lymphomas: Current understanding and future directions","volume":"108","author":"Bisig","year":"2023","journal-title":"Haematologica"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1182\/blood.2022018752","article-title":"DLBCL-associated NOTCH2 mutations escape ubiquitin-dependent degradation and promote chemoresistance","volume":"142","author":"Zhou","year":"2023","journal-title":"Blood"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1084\/jem.20120904","article-title":"The coding genome of splenic marginal zone lymphoma: Activation of NOTCH2 and other pathways regulating marginal zone development","volume":"209","author":"Rossi","year":"2012","journal-title":"J. Exp. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1182\/blood.2024025794","article-title":"EMZL at various sites: Learning from each other","volume":"145","author":"Du","year":"2025","journal-title":"Blood"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1759","DOI":"10.1182\/blood.2024026020","article-title":"Biology as vulnerability in follicular lymphoma: Genetics, epigenetics, and immunogenetics","volume":"146","year":"2025","journal-title":"Blood"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Doba\u00f1o-L\u00f3pez, C., Araujo-Ayala, F., Serrat, N., Valero, J.G., and P\u00e9rez-Gal\u00e1n, P. (2021). Follicular Lymphoma Microenvironment: An Intricate Network Ready for Therapeutic Intervention. Cancers, 13.","DOI":"10.3390\/cancers13040641"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1186\/s13000-018-0750-8","article-title":"PD1hi cells associate with clusters of proliferating B-cells in marginal zone lymphoma","volume":"13","author":"Wickenden","year":"2018","journal-title":"Diagn. Pathol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.cell.2016.08.032","article-title":"Loss of the HVEM Tumor Suppressor in Lymphoma and Restoration by Modified CAR-T Cells","volume":"167","author":"Boice","year":"2016","journal-title":"Cell"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1016\/j.immuni.2019.04.011","article-title":"T Follicular Helper Cell Biology: A Decade of Discovery and Diseases","volume":"50","author":"Crotty","year":"2019","journal-title":"Immunity"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"9166","DOI":"10.1158\/0008-5472.CAN-10-2460","article-title":"Acquired TNFRSF14 mutations in follicular lymphoma are associated with worse prognosis","volume":"70","author":"Cheung","year":"2010","journal-title":"Cancer Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2412","DOI":"10.1038\/s41375-018-0082-4","article-title":"High-throughput sequencing of nodal marginal zone lymphomas identifies recurrent BRAF mutations","volume":"32","author":"Pillonel","year":"2018","journal-title":"Leukemia"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1182\/blood-2016-02-696757","article-title":"The genetics of nodal marginal zone lymphoma","volume":"128","author":"Spina","year":"2016","journal-title":"Blood"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e70065","DOI":"10.1002\/hem3.70065","article-title":"Detection of clinically relevant variants in the TP53 gene below 10% allelic frequency: A multicenter study by ERIC, the European Research Initiative on CLL","volume":"9","author":"Pavlova","year":"2025","journal-title":"Hemasphere"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"5082","DOI":"10.1182\/bloodadvances.2022009467","article-title":"Subclonal TP53 mutations are frequent and predict resistance to radioimmunotherapy in follicular lymphoma","volume":"7","author":"Burack","year":"2023","journal-title":"Blood Adv."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1038\/s41375-018-0043-y","article-title":"Genomic profiling reveals spatial intra-tumor heterogeneity in follicular lymphoma","volume":"32","author":"Araf","year":"2018","journal-title":"Leukemia"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1007\/s00277-024-06175-z","article-title":"Genetic alterations and their prognostic impact in marginal zone lymphoma: A meta-analysis","volume":"104","author":"Li","year":"2025","journal-title":"Ann. Hematol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1007\/s00428-021-03186-3","article-title":"Mutational landscape of marginal zone B-cell lymphomas of various origin: Organotypic alterations and diagnostic potential for assignment of organ origin","volume":"480","author":"Vela","year":"2022","journal-title":"Virchows Arch."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"4351","DOI":"10.1182\/blood-2024-210085","article-title":"Genetic Characterization of Marginal Zone Lymphomas in Tissue and cfDNA","volume":"144","author":"Lafuente","year":"2024","journal-title":"Blood"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1111\/ejh.13755","article-title":"Health economic evidence for the use of molecular biomarker tests in hematological malignancies: A systematic review","volume":"108","author":"Vu","year":"2022","journal-title":"Eur. J. Haematol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2193","DOI":"10.1182\/blood.2022015854","article-title":"Genomic profiling for clinical decision making in lymphoid neoplasms","volume":"140","author":"Alizadeh","year":"2022","journal-title":"Blood"},{"key":"ref_47","first-page":"1043","article-title":"A genetic profiling guideline to support diagnosis and clinical management of lymphomas","volume":"26","author":"Guirado","year":"2024","journal-title":"Clin. Transl. Oncol."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Cappello, F., Angerilli, V., Munari, G., Ceccon, C., Sabbadin, M., Pagni, F., Fusco, N., Malapelle, U., and Fassan, M. (2022). FFPE-Based NGS Approaches into Clinical Practice: The Limits of Glory from a Pathologist Viewpoint. J. Pers. Med., 12.","DOI":"10.3390\/jpm12050750"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1016\/j.jmoldx.2021.06.005","article-title":"Next-Generation Sequencing-Based Clonality Assessment of Ig Gene Rearrangements: A Multicenter Validation Study by EuroClonality-NGS","volume":"23","author":"Rijntjes","year":"2021","journal-title":"J. Mol. Diagn"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/joim.13508","article-title":"Application of precision medicine in clinical routine in haematology\u2014Challenges and opportunities","volume":"292","author":"Cavelier","year":"2022","journal-title":"J. Intern. Med."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Coccaro, N., Tota, G., Anelli, L., Zagaria, A., Specchia, G., and Albano, F. (2020). Digital PCR: A Reliable Tool for Analyzing and Monitoring Hematologic Malignancies. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21093141"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1111\/j.1751-553X.2008.01100.x","article-title":"International Council for Standardization In Hematology. ICSH guidelines for the standardization of bone marrow specimens and reports","volume":"30","author":"Lee","year":"2008","journal-title":"Int. J. Lab. Hematol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1111\/ijlh.12365","article-title":"ICSH guidelines for the standardization of bone marrow immunohistochemistry","volume":"37","author":"Torlakovic","year":"2015","journal-title":"Int. J. Lab. Hematol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1038\/s41375-019-0496-7","article-title":"Standardized next-generation sequencing of immunoglobulin and T-cell receptor gene recombinations for MRD marker identification in acute lymphoblastic leukaemia; a EuroClonality-NGS validation study","volume":"33","author":"Knecht","year":"2019","journal-title":"Leukemia"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2227","DOI":"10.1038\/s41375-019-0508-7","article-title":"Next-generation sequencing of immunoglobulin gene rearrangements for clonality assessment: A technical feasibility study by EuroClonality-NGS","volume":"33","author":"Scheijen","year":"2019","journal-title":"Leukemia"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/1\/51\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T14:28:34Z","timestamp":1766500114000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/1\/51"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,20]]},"references-count":55,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["ijms27010051"],"URL":"https:\/\/doi.org\/10.3390\/ijms27010051","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,20]]}}}