Schematic of IGH gene development from germline configuration (top) to mature B-cell/clonal myeloma cell (bottom). Somatic Hypermutation occurs in the germinal center. Insertions and deletions may involve all segments of the gene. Each mature B cell will have a unique sequence and, in the case of clonal plasma cells, will be clonally detectable by deep sequencing.
Clonoseq/LymphoSIGHT assay uses a V primer and then J and tagged primers in sequence. LymphoTrack uses primers for framework regions FR1,FR2, and FR3 primers with an upstream leader sequence. IgK assays are in use but not pictured and IgL assays are in development. [89, 103].