Single-cell PCR analysis of the immunoglobulin heavy chain CDR3 region for the diagnosis of leptomeningeal involvement of B-cell malignancies

Background: The diagnosis of leptomeningeal B-cell malignancies is based on identification of malignant B-cells in the CSF. Molecular analysis of B-cell clonality in CSF samples via amplification and size determination of the highly diverse CDR3-IgH region is a useful approach to distinguish neoplastic from reactive B-cell responses within the CSF and supplements standard diagnostic procedures such as cytology, immuncytochemistry, and flow cytometry. However, the molecular analysis of B-cells using whole CSF specimens is limited if leucemic or lymphomatous spread to the leptomeninges is accompanied by a reactive…