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Test Code RBCS Relative B-Cell Subset Analysis Percentage, Blood

Reporting Name

Relative B Cell Subset Analysis %

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Screening for humoral or combined immunodeficiencies, including common variable immunodeficiency, hyper IgM syndrome, among others, where B-cell subset distribution information is desired

 

Assessing B-cell subset reconstitution after hematopoietic cell or bone marrow transplant

 

Assessing B-cell subset reconstitution following recovery of B cells after B-cell-depleting immunotherapy

 

This test is not indicated for the evaluation of lymphoproliferative disorders (eg, leukemia, lymphoma, multiple myeloma).

 

This test should not be used to monitor B-cell counts to assess B-cell depletion in patients on B-cell-depleting therapies.

Method Name

Flow Cytometry


Ordering Guidance


This test should be ordered only when percentages are needed for the reportable B-cell subsets. If both percentages and absolute counts are needed for the reportable B-cell subsets, order IABCS / B-Cell Phenotyping Profile for Immunodeficiency and Immune Competence Assessment, Blood.



Shipping Instructions


Testing performed Monday through-Friday. Specimens not received by 4 p.m. Central time on Fridays may be canceled.

 

Specimens arriving on the weekend and observed holidays may be canceled.

 

Collect and package specimens as close to shipping time as possible. Ship specimens overnight.

 

It is recommended that specimens arrive within 24 hours of collection.



Necessary Information


The ordering healthcare professional's name and phone number are required.



Specimen Required


Container/Tube: Lavender top (EDTA)

Specimen Volume:

≤14 years: 4 mL

>14 years: 10 mL

Collection Instructions:

1. Send whole blood specimen in original tube. Do not aliquot.

2. Label specimen as blood for RBCS.

Additional Information: For serial monitoring, it is recommended that specimens are collected at the same time of day.


Specimen Type

Whole Blood EDTA

Specimen Minimum Volume

≤14 years: 3 mL; >14 years: 5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Whole Blood EDTA Refrigerated 48 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

The assay provides semiquantitative information on the various B-cell subsets. Each specimen is evaluated for B-cell subsets with respect to the total number of CD19+ B cells present in the peripheral blood mononuclear cell population, compared to the reference range. In order to verify that there are no CD19-related defects, CD20 is used as an additional pan-B-cell marker (expressed as percentage of CD45+ lymphocytes).

 

The B-cell panel assesses the following B-cell subsets:

CD19+=B cells expressing CD19 as a percent of total lymphocytes

CD19+ CD27+=total memory B cells

CD19+ CD27+ IgD+ IgM+=marginal zone or non-switched memory B cells

CD19+ CD27+ IgD- IgM+=IgM-only memory B cells

CD19+ CD27+ IgD- IgM-=class-switched memory B cells

CD19+ IgM+=IgM B cells

CD19+ CD38+ IgM+=transitional B cells

CD19+ CD38+ IgM-=plasmablasts

CD19+ CD21-=CD21-negative B cells

CD19+ CD21+=CD21-positive B cells

CD19+ CD20+=B cells coexpressing both CD19 and CD20 as a percent of total lymphocytes

Day(s) Performed

Monday through Friday

Report Available

3 to 4 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

86356 x7

LOINC Code Information

Test ID Test Order Name Order LOINC Value
RBCS Relative B Cell Subset Analysis % 90416-9

 

Result ID Test Result Name Result LOINC Value
BCD19 CD19+ % of total Lymphocytes 8117-4
BCD20 CD20+ % of total Lymphocytes 8119-0
BCD27 CD27+ % of CD19+ B Cells 89358-6
B27MD CD27+ IgM+ IgD+ % of CD19+ B Cells 89352-9
B27N CD27+ IgM- IgD- % of CD19+ B Cells 89350-3
B27M CD27+ IgM+ IgD- % of CD19+ B Cells 89348-7
BIGM IgM+ % of CD19+ B Cells 89346-1
B38MN CD38+ IgM- % of CD19+ B Cells 89344-6
B38MP CD38+ IgM+ % of CD19+ B Cells 89341-2
B21P CD21+ % of CD19+ B Cells 89356-0
B21N CD21- % of CD19+ B Cells 89355-2
RBCSI Interpretation 69048-7