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B-cell Immunoglobulin Gene Rearrangement

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Also known as: Immunoglobulin Gene Rearrangement; B-cell Gene Clonality Molecular Genetic Tests; BCGR
Formal name: B-cell Gene Rearrangement

At a Glance

Why Get Tested?

To help diagnose a B-cell lymphoma; to detect and evaluate residual cancer cells

When to Get Tested?

When a doctor thinks that you may have a B-cell lymphoma; sometimes to evaluate the effectiveness of treatment or to evaluate for recurrent disease

Sample Required?

A bone marrow, tissue (biopsy), or body fluid sample collected by your doctor; sometimes a blood sample drawn from a vein in your arm

Test Preparation Needed?

None

The Test Sample

What is being tested?

This test detects characteristic changes (rearrangements) in specific genes in B-cells. This information can be helpful in diagnosing a B-cell lymphoma.

B-cells are a type of lymphocyte (a kind of white blood cell, WBC) that produces antibodies in response to infections or other "foreign invaders." Rearrangements in certain parts of their DNA called immunoglobulin genes are a normal part of their development. These rearrangements are associated with the development of a large repertoire of diverse B-cells, allowing them to protect against many different kinds of infections. The final order in which the genes are rearranged is called a gene rearrangement profile. Within any normal population (sample) of B-cells, the cells and their gene rearrangement profiles are very diverse.

In a lymphoma, the B-cells in affected tissue (such as blood, bone marrow or lymph node) are identical and their gene rearrangement profiles are likewise identical. Lymphomas arise when an abnormal B-cell begins to produce numerous identical copies of itself (clones). The cloned cells grow and divide uncontrollably, crowding out normal cells.

A B-cell immunoglobulin gene rearrangement test evaluates the B-cells in a person's sample to determine whether the majority of B-cell rearrangement profiles are diverse or identical. This information, along with clinical signs and symptoms and results of other laboratory tests, can help clarify a person's diagnosis, or evaluate the persistence or recurrence of lymphoma.

About 85% of non-Hodgkin lymphomas in the U.S. are B-cell lymphomas, according to the American Cancer Society (ACS).

For additional details about B-cells and this testing, read more.

How is the sample collected for testing?

A bone marrow or other tissue biopsy procedure is performed by a doctor or other trained specialist. Body fluid samples are obtained by inserting a needle into the body cavity and withdrawing a portion of the fluid with a syringe. Sometimes, a blood sample is obtained by inserting a needle into a vein in the arm.

NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.

Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.

Is any test preparation needed to ensure the quality of the sample?

No test preparation is needed.

The Test

Common Questions

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Article Sources

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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.

Gajra, A. and Vajpayee, N. (Updated 2012 January 20). B-Cell Lymphoma. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/202677-overview through http://emedicine.medscape.com. Accessed June 2012.

(© 1995–2012). Test ID: BCGRV Immunoglobulin Gene Rearrangement, Varies. Mayo Clinic Mayo Medical Laboratories [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/Overview/31142 through http://www.mayomedicallaboratories.com. Accessed June 2012.

Bahler, D. et. al. (Updated 2012 May). Lymphomas, B-Cell - B-Cell Lymphomas. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/LymphomaBCell.html?client_ID=LTD through http://www.arupconsult.com. Accessed June 2012.

Kempf, W. and Burg, G. (Updated 2011 June 1). Cutaneous B-Cell Lymphoma. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/1099540-overview#showall through http://emedicine.medscape.com. Accessed June 2012.

(Updated 2011 November 28). Combined B-Cell and T-Cell Disorders. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/210249-overview#showall through http://emedicine.medscape.com. Accessed June 2012.

(Revised 2012 January 26). Non-Hodgkin Lymphoma, Detailed Guide. American Cancer Society [On-line information]. Available online at http://www.cancer.org/Cancer/Non-HodgkinLymphoma/DetailedGuide/index through http://www.cancer.org. Accessed June 2012.

Pignataro Lima, F. (2008). Primary Diffuse Large B-Cell Lymphoma of Bone Displays Preferential Rearrangements of the c-MYC or BCL2 Gene. Am J Clin Pathol 2008;129:723-726. [On-line information]. PDF available for download at http://ajcp.ascpjournals.org/content/129/5/723.full.pdf through http://ajcp.ascpjournals.org. Accessed June 2012.

Shustik, J. et. al. (2009 October 1). Correlations between BCL6 rearrangement and outcome in patients with diffuse large B-cell lymphoma treated with CHOP or R-CHOP. Haematol v95 (1) 96-101 [On-line information]. Available online at http://www.haematologica.org/content/95/1/96.full through http://www.haematologica.org. Accessed June 2012.

González, D. et. al. (2007 July 18). Immunoglobulin gene rearrangements and the pathogenesis of multiple myeloma. Blood v110 (9) 3112-3121. [On-line information]. Available online at http://bloodjournal.hematologylibrary.org/content/110/9/3112.full through http://bloodjournal.hematologylibrary.org. Accessed June 2012.

(Reviewed December 2011). B-Cell Gene Rearrangement, Qualitative PCR. Quest Diagnostics [On-line information]. Available online at http://www.questdiagnostics.com/testcenter/testguide.action?fn=TH_BcellGene.htm through http://www.questdiagnostics.com. Accessed June 2012.

Delves, P. (Revised 2008 September). Components of the Immune System. Merck Manual for Healthcare Professionals [On-line information]. Available online through http://www.merckmanuals.com. Accessed June 2012.

Leonard, D. G. B., Editor (© 2009). Molecular Pathology in Clinical Practice: Oncology: Springer Science + Business Media, LLC., New York, NY. Pp 179-194.

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