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Test Code Billings Clinic: 8401 Mayo: TBBS Quantitative Lymphocyte Subsets: T, B, and Natural Killer (NK) Cells, Blood

Reporting Name

QN Lymphocyte Subsets: T, B, and NK

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Serial monitoring of CD4 T-cell count in patients who are HIV-positive

 

Follow-up and diagnostic evaluation of primary immunodeficiencies, including severe combined immunodeficiency

 

Immune monitoring following immunosuppressive therapy for transplantation, autoimmunity, and other immunological conditions where such treatment is utilized

 

Assessment of immune reconstitution post-hematopoietic cell transplantation

 

Early screening of gross quantitative anomalies in lymphocyte subsets in infection or malignancies

 

Absolute quantitation of circulating B cells for diagnosis of patients with chronic lymphocytic leukemia as indicated in the 2008 International Workshop on Chronic Lymphocytic Leukemia guidelines

Method Name

Flow Cytometry


Ordering Guidance


This assay should not be used for diagnosing lymphocytic malignancies or evaluation of lymphocytosis of unknown etiology. For such cases, order LCMS / Leukemia/Lymphoma Immunophenotyping, Flow Cytometry, Varies, which includes a hematopathology review.

 

This assay can be used for absolute quantitation of B cells in patients with chronic lymphocytic leukemia.

 

While this assay can be used to follow patients on B-cell-depleting therapy, like rituximab (eg, Rituxan, Riabni) or ofatumumab (eg, Kesimpta), it may be more reasonable and financially viable to use CD20B / CD20 on B Cells, Blood (includes CD45, CD19 and CD20 markers).



Shipping Instructions


It is recommended that specimens arrive within 24 hours of collection. Collect and package specimen as close to shipping time as possible.



Necessary Information


Date and time of collection are required.



Specimen Required


Container/Tube: Lavender top (EDTA)

Specimen Volume: 3 mL

Collection Instructions: Send whole blood specimen in original tube. Do not aliquot.

Additional Information: For serial monitoring, it is recommended that specimen collection be performed at the same time of day.


Billings Clinic Note:

This is a time sensitive test.  Please draw this test Monday - Wednesday ONLY

Specimen Type

Whole Blood EDTA

Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Whole Blood EDTA Ambient 52 hours PURPLE OR PINK TOP/EDTA

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject

Reference Values

The appropriate age-related reference values will be provided on the report.

Interpretation

HIV treatment guidelines from the US Department of Health and Human Services and the International Antiviral Society-USA Panel recommend antiviral treatment in all patients with HIV infection, regardless of CD4 T-cell count.(10,11) Additionally, antibiotic prophylaxis for Pneumocystis jiroveci infection is recommended for patients with CD4 count less than 200 cells/mcL. For other opportunistic infections, see the recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America.(12)

Day(s) Performed

Monday through Sunday

Report Available

Same day/1 to 2 days

Test Classification

This test was developed using an analyte specific reagent. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

86355

86357

86359

86360

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TBBS QN Lymphocyte Subsets: T, B, and NK 80721-4

 

Result ID Test Result Name Result LOINC Value
3321 CD45 Total Lymph Count 27071-0
3316 % CD3 (T Cells) 8124-0
3322 CD3 (T Cells) 8122-4
3319 % CD4 (T Cells) 8123-2
3325 CD4 (T Cells) 24467-3
3320 % CD8 (T Cells) 8101-8
3326 CD8 (T Cells) 14135-8
3318 % CD19 (B Cells) 8117-4
3324 CD19 (B Cells) 8116-6
4054 % CD16+CD56 (NK cells) 8112-5
4055 CD16+CD56 (NK cells) 20402-4
3327 4/8 Ratio 54218-3
6657 Comment 80722-2