Acute Myelogenous Leukemia (AML) Support Group

Acute myelogenous leukemia (AML), also known as acute myeloid leukemia, is a cancer of the myeloid line of blood cells. Patients with AML usually present with symptoms such as fatigue, bleeding, infection, prompting medical attention. An abnormal blood test reading will then result in further testing in a hospital with a hematologist to determine AML.

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coinlieutenant 04/13/2016

All has been going pretty well lately, medically, until I got a concerning test result in my health portal today. I am positive for TCRG gene rearrangement. It says "Clonal T cell receptor gamma chain (TCRG) gene rearrangement detected." I never had any abnormal or clonal lymphocytes before the transplant, but a quick google search confirmed my fear that this could be an indication of PTLD, or essentially transplant-induced lymphoma. I am waiting to hear back from my doctor. My hematologist who is still following me for systemic mastocytosis is the one who put the order in, and he said it was just for research. He told me not to worry, that I don't have lymphoma, but he is waiting to confer with my BMT doc about any post-transplant cause for this clonal T-cell population. Can anyone enlighten me?

xuelan 04/14/2016

John,

I combed PubMed for some type of association between TCRG gene rearrangement and mastocytosis, and could not find anything. There does seem to be a relationship between CEL and systemic mastocytosis, however, but I still think that as your new marrow firmly takes over the mastocytosis will be taken care of by your new immune system. Perhaps your T-lymphocytes are in overdrive right now causing the clonal proliferation. Since the test is investigational and not routinely done, I would wonder what the levels of this gene rearrangement pattern would have been early on in rest of us who had transplants I would really wonder what the TCRG rearrangement level would be some months down the line. Please let me know what further tests your doctors are planning to do right now, if anything.

Thinking of you.

Cliff

coinlieutenant 04/14/2016

Thanks Cliff. SM and CEL certainly exist together and are linked since Eos and mast cells hang out in the same biological circles.

The T-cell thing is perplexing. I guess I don't understand what exactly that test does (TCRG). I know it is looking for monoclonality but the gene rearrangement is what has me concerned.

All a mystery is my marrow and my disease(s)

John

mondreamr1 04/18/2016

I had oligoclonal populations on the test when I had blood count issues about 6 months out. Doc was actually testing for LGL leukemia. My platelets dropped from 107 to 7 in 10 days. Reds showed hemolytic anemia. It got called Evans Syndrome, even though the combs test was wacky. Steroids, tacro, and rituximab (actually targets B cells) got whatever was going on knocked back. Took 9 months and a bunch of trial and error and more Rituximab and another inpatient visit with a regular Hematologist to get things finally straight. They finally called it a very weird manifestation of GVHD That was more GvG it was my blood cells it was attacking. I had lymphs in my bone marrow when they biopsied it (then lead to a pertussis test - negative)

I hope your docs get things straightened out for you quickly.

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