EHA Library - The official digital education library of European Hematology Association (EHA)

MULTI-CENTER VALIDATION OF STANDARDIZED NGS ASSAYS FOR REARRANGED IG / TR MARKER DETECTION IN ACUTE LYMPHOBLASTIC LEUKEMIA - A REPORT OF THE EUROCLONALITY-NGS CONSORTIUM
Author(s): ,
Monika Brüggemann
Affiliations:
Medical Department II, Unit for Hematological Diagnostics,University Hospital Schleswig-Holstein,Kiel,Germany
,
Henrik Knecht
Affiliations:
Medical Department II, Unit for Hematological Diagnostics,University Hospital Schleswig-Holstein,Kiel,Germany
,
Michaela Kotrová
Affiliations:
Medical Department II, Unit for Hematological Diagnostics,University Hospital Schleswig-Holstein,Kiel,Germany;CLIP - Childhood Leukemia Investigation Prague, Dpt. of Pediatric Hematology/Oncology,Second Faculty of Medicine and University Hospital Motol,Prague,Czech Republic
,
Jack Bartram
Affiliations:
Department of Pediatric Hematology,Great Ormond Street Hospital For Children and UCL Institute of Child Health,London,United Kingdom
,
Vojtech Bystry
Affiliations:
Central European Institute of Technology,Masaryk University,Brno,Czech Republic
,
Nikos Darzentas
Affiliations:
Central European Institute of Technology,Masaryk University,Brno,Czech Republic
,
Frederic Davi
Affiliations:
Centre de génétique moléculaire et chromosomique,Hôpital Pitié-Salpêtrière,Paris,France
,
Grazia Fazio
Affiliations:
Centro Ricerca Tettamanti, Clinica Pediatrica,Università di Milano-Bicocca,Monza,Italy
,
Eva Fronkova
Affiliations:
CLIP - Childhood Leukemia Investigation Prague, Dpt. of Pediatric Hematology/Oncology,Second Faculty of Medicine and University Hospital Motol,Prague,Czech Republic
,
Ramon García-Sanz
Affiliations:
Department of Hematology,Hospital Universitario de Salamanca,Salamanca,Spain
,
Mathieu Giraud
Affiliations:
CRIStAL (Centre de Recherche en Informatique, Signal et Automatique de Lille), Unité Mixte de Recherche (UMR CNRS 9189),Université de Lille and Inria Lille,Lile,France
,
Andrea Grioni
Affiliations:
Centro Ricerca Tettamanti, Clinica Pediatrica,Università di Milano-Bicocca,Monza,Italy
,
Patricia JTA Groenen
Affiliations:
Department of Pathology,Radboud University Medical Center,Nijmegen,Netherlands
,
Jeremy Hancock
Affiliations:
Bristol Genetics Laboratory,Southmead Hospital,Bristol,United Kingdom
,
Dietrich Herrmann
Affiliations:
Medical Department II, Unit for Hematological Diagnostics,University Hospital Schleswig-Holstein,Kiel,Germany
,
Michael Hummel
Affiliations:
Institut für Pathologie,Universitätsmedizin Berlin,Berlin,Germany
,
Cristina Jimenez
Affiliations:
Department of Hematology,Hospital Universitario de Salamanca,Salamanca,Spain
,
Adam Krejci
Affiliations:
Central European Institute of Technology,Masaryk University,Brno,Czech Republic
,
Christiane Pott
Affiliations:
Medical Department II, Unit for Hematological Diagnostics,University Hospital Schleswig-Holstein,Kiel,Germany
,
Tomas Riegl
Affiliations:
Central European Institute of Technology,Masaryk University,Brno,Czech Republic
,
Mikael Salson
Affiliations:
CRIStAL (Centre de Recherche en Informatique, Signal et Automatique de Lille), Unité Mixte de Recherche (UMR CNRS 9189),Université de Lille and Inria Lille,Lile,France
,
Martin Schwarz
Affiliations:
Medical Department II, Unit for Hematological Diagnostics,University Hospital Schleswig-Holstein,Kiel,Germany
,
Simona Songia
Affiliations:
Centro Ricerca Tettamanti, Clinica Pediatrica,Università di Milano-Bicocca,Monza,Italy
,
Andrea Svenkrtova
Affiliations:
CLIP - Childhood Leukemia Investigation Prague, Dpt. of Pediatric Hematology/Oncology,Second Faculty of Medicine and University Hospital Motol,Prague,Czech Republic
,
Patrick Villarese
Affiliations:
Laboratoire d'hématologie,Hôpital Necker,Paris,France
,
Giovanni Cazzaniga
Affiliations:
Centro Ricerca Tettamanti, Clinica Pediatrica,Università di Milano-Bicocca,Monza,Italy
,
Jacques JM van Dongen
Affiliations:
Dept. of Immunohematology and Blood Transfusion,Leiden University Medical Center,Leiden,Netherlands
,
Elizabeth A. Macintyre
Affiliations:
Laboratoire d'hématologie,Hôpital Necker,Paris,France
,
John Mopett
Affiliations:
Department of Pediatric Haematology,Bristol Royal Hospital for Children,Bristol,United Kingdom
,
Jan Trka
Affiliations:
CLIP - Childhood Leukemia Investigation Prague, Dpt. of Pediatric Hematology/Oncology,Second Faculty of Medicine and University Hospital Motol,Prague,Czech Republic
Anton W. Langerak
Affiliations:
Department of Immunology,Erasmus MC,Rotterdam,Netherlands
(Abstract release date: 05/18/17) EHA Library. Brüggemann M. 06/25/17; 182088; S801
Prof. Dr. Monika Brüggemann
Prof. Dr. Monika Brüggemann
Contributions
Abstract

Abstract: S801

Type: Oral Presentation

Presentation during EHA22: On Sunday, June 25, 2017 from 08:30 - 08:45

Location: Room N103

Background
Amplicon-based next generation sequencing (NGS) of immunoglobulin (IG) and T-cell receptor (TR) gene rearrangements can be used to identify suitable markers for subsequent quantification of minimal residual disease (MRD) in acute lymphoblastic leukemia (ALL). Within the EuroClonality-NGS Consortium we established and validated a standardized quality controlled amplicon-based NGS application to detect clonally rearranged IGH, IGK, TRB, TRG and TRD genes in lymphoid disorders.

Aims

1) to test EuroClonality-NGS IG / TR NGS assays within an international multi-laboratory pilot for their suitability to identify clonal markers in ALL at diagnosis, and
2) to compare these NGS results with conventional Sanger sequencing (SS) of Genescan or Heteroduplex peaks/bands local multiplex PCRs

Methods
Within the EuroClonality-NGS Consortium, V, D, and J gene-specific primers tailed with universal and T7-linker sequences, were designed to amplify complete and incomplete IGH, IGK, TRB, TRG or TRD gene rearrangements employing eight different multiplex PCR assays. PCR protocols were standardized in a common NGS workflow for all targets. NGS assays were tested in a European multi-laboratory pilot run in five institutes (Kiel, Bristol, Prague, Monza, Paris). Diagnostic DNA (100ng) from 10 ALL patients per centre were amplified in each institute using the EuroClonality NGS primer sets, and subsequently sequenced on the Illumina MiSeq (2×250bp v2 kit). Defined copy numbers of clonal reference DNAs were spiked into all samples for calculation of clonotype copy numbers. A standard polytarget quality control (QC) DNA was used to monitor inter- and intra-lab NGS reproducibility. Results of NGS based marker identification were compared to results of routine SS results.

Results

Fifty ALLs (29 BCP-ALL and 21 T-ALL) were analysed. A total of 480 libraries were deep sequenced, leading to 47 M high quality reads (ᴓ 9.2 M/lab). Pre-processing, identification and immunogenetic annotation of target sequences, quality control and copy number calculations, were performed with ARResT/Interrogate, using IMGT germline sequences – further analyses and verifications were performed with Vidjil and IMGT/V-QUEST.
Overall, 339 clonal IG / TR sequences were identified, with a mean of 6.3 (2-13)/sample using NGS vs. 5.0 (2-13)/sample using SS. A total of 228/339 (68%) clonal sequences were concordant between both methods. NGS identified additional clonal rearrangements in 88 (26%) libraries, whereas 23 (7%) clonal markers were only detected by SS. NGS primers covered possible IG /TR rearrangement types more completely compared to local multiplex PCR sets and enabled sequencing of bi-allelic rearrangements and weak PCR products. Currently discrepant cases are analysed in more detail using allele-specific PCR assays. Assay performance was analysed by standardized evaluation of QC samples and showed high intra- and inter-lab consistency without statistically significant differences between the labs.

Conclusion
The IG / TR NGS panel, as established by the EuroClonality-NGS Consortium, allows for quality controlled high-throughput detection of clonal IG /TR rearrangements in ALL. Compared to low throughput methods more clonal MRD markers are identified, sensitivity is increased, processing time is reduced and labour intensive conventional methods to resolve mixed sequences in case of bi-allelic rearrangements or background are avoided.

Session topic: 1. Acute lymphoblastic leukemia - Biology

Keyword(s): Molecular markers, Minimal residual disease (MRD), Ig and TCR gene rearrangement, Acute lymphoblastic leukemia

Abstract: S801

Type: Oral Presentation

Presentation during EHA22: On Sunday, June 25, 2017 from 08:30 - 08:45

Location: Room N103

Background
Amplicon-based next generation sequencing (NGS) of immunoglobulin (IG) and T-cell receptor (TR) gene rearrangements can be used to identify suitable markers for subsequent quantification of minimal residual disease (MRD) in acute lymphoblastic leukemia (ALL). Within the EuroClonality-NGS Consortium we established and validated a standardized quality controlled amplicon-based NGS application to detect clonally rearranged IGH, IGK, TRB, TRG and TRD genes in lymphoid disorders.

Aims

1) to test EuroClonality-NGS IG / TR NGS assays within an international multi-laboratory pilot for their suitability to identify clonal markers in ALL at diagnosis, and
2) to compare these NGS results with conventional Sanger sequencing (SS) of Genescan or Heteroduplex peaks/bands local multiplex PCRs

Methods
Within the EuroClonality-NGS Consortium, V, D, and J gene-specific primers tailed with universal and T7-linker sequences, were designed to amplify complete and incomplete IGH, IGK, TRB, TRG or TRD gene rearrangements employing eight different multiplex PCR assays. PCR protocols were standardized in a common NGS workflow for all targets. NGS assays were tested in a European multi-laboratory pilot run in five institutes (Kiel, Bristol, Prague, Monza, Paris). Diagnostic DNA (100ng) from 10 ALL patients per centre were amplified in each institute using the EuroClonality NGS primer sets, and subsequently sequenced on the Illumina MiSeq (2×250bp v2 kit). Defined copy numbers of clonal reference DNAs were spiked into all samples for calculation of clonotype copy numbers. A standard polytarget quality control (QC) DNA was used to monitor inter- and intra-lab NGS reproducibility. Results of NGS based marker identification were compared to results of routine SS results.

Results

Fifty ALLs (29 BCP-ALL and 21 T-ALL) were analysed. A total of 480 libraries were deep sequenced, leading to 47 M high quality reads (ᴓ 9.2 M/lab). Pre-processing, identification and immunogenetic annotation of target sequences, quality control and copy number calculations, were performed with ARResT/Interrogate, using IMGT germline sequences – further analyses and verifications were performed with Vidjil and IMGT/V-QUEST.
Overall, 339 clonal IG / TR sequences were identified, with a mean of 6.3 (2-13)/sample using NGS vs. 5.0 (2-13)/sample using SS. A total of 228/339 (68%) clonal sequences were concordant between both methods. NGS identified additional clonal rearrangements in 88 (26%) libraries, whereas 23 (7%) clonal markers were only detected by SS. NGS primers covered possible IG /TR rearrangement types more completely compared to local multiplex PCR sets and enabled sequencing of bi-allelic rearrangements and weak PCR products. Currently discrepant cases are analysed in more detail using allele-specific PCR assays. Assay performance was analysed by standardized evaluation of QC samples and showed high intra- and inter-lab consistency without statistically significant differences between the labs.

Conclusion
The IG / TR NGS panel, as established by the EuroClonality-NGS Consortium, allows for quality controlled high-throughput detection of clonal IG /TR rearrangements in ALL. Compared to low throughput methods more clonal MRD markers are identified, sensitivity is increased, processing time is reduced and labour intensive conventional methods to resolve mixed sequences in case of bi-allelic rearrangements or background are avoided.

Session topic: 1. Acute lymphoblastic leukemia - Biology

Keyword(s): Molecular markers, Minimal residual disease (MRD), Ig and TCR gene rearrangement, Acute lymphoblastic leukemia

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