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Open Access 01-08-2021 | Polymerase Chain Reaction | Original Article

Evaluation of a worldwide EQA scheme for complex clonality analysis of clinical lymphoproliferative cases demonstrates a learning effect

Authors: Cleo Keppens, Elke Boone, Paula Gameiro, Véronique Tack, Elisabeth Moreau, Elizabeth Hodges, Paul Evans, Monika Brüggemann, Ian Carter, Dido Lenze, Maria Eugenia Sarasquete, Markus Möbs, Hongxiang Liu, Elisabeth M. C. Dequeker, Patricia J. T. A. Groenen

Published in: Virchows Archiv | Issue 2/2021

Abstract

Clonality analysis of immunoglobulin (IG) or T-cell receptor (TR) gene rearrangements is routine practice to assist diagnosis of lymphoid malignancies. Participation in external quality assessment (EQA) aids laboratories in identifying systematic shortcomings. The aim of this study was to evaluate laboratories’ improvement in IG/TR analysis and interpretation during five EQA rounds between 2014 and 2018. Each year, participants received a total of five cases for IG and five cases for TR testing. Paper-based cases were included for analysis of the final molecular conclusion that should be interpreted based on the integration of the individual PCR results. Wet cases were distributed for analysis of their routine protocol as well as evaluation of the final molecular conclusion. In total, 94.9% (506/533) of wet tests and 97.9% (829/847) of paper tests were correctly analyzed for IG, and 96.8% (507/524) wet tests and 93.2% (765/821) paper tests were correctly analyzed for TR. Analysis scores significantly improved when laboratories participated to more EQA rounds (p=0.001). Overall performance was significantly lower (p=0.008) for non-EuroClonality laboratories (95% for IG and 93% for TR) compared to EuroClonality laboratories (99% for IG and 97% for TR). The difference was not related to the EQA scheme year, anatomic origin of the sample, or final clinical diagnosis. This evaluation showed that repeated EQA participation helps to reduce performance differences between laboratories (EuroClonality versus non-EuroClonality) and between sample types (paper versus wet). The difficulties in interpreting oligoclonal cases highlighted the need for continued education by meetings and EQA schemes.

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Title: Evaluation of a worldwide EQA scheme for complex clonality analysis of clinical lymphoproliferative cases demonstrates a learning effect
Authors: Cleo Keppens
Elke Boone
Paula Gameiro
Véronique Tack
Elisabeth Moreau
Elizabeth Hodges
Paul Evans
Monika Brüggemann
Ian Carter
Dido Lenze
Maria Eugenia Sarasquete
Markus Möbs
Hongxiang Liu
Elisabeth M. C. Dequeker
Patricia J. T. A. Groenen
Publication date: 01-08-2021
Publisher: Springer Berlin Heidelberg
Keyword: Polymerase Chain Reaction
Published in: Virchows Archiv / Issue 2/2021
Print ISSN: 0945-6317
Electronic ISSN: 1432-2307
DOI: https://doi.org/10.1007/s00428-021-03046-0

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Evaluation of a worldwide EQA scheme for complex clonality analysis of clinical lymphoproliferative cases demonstrates a learning effect

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