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For hours, walk-ins and appointments.Helper/Suppressor and Natural Killer Cell Profile
CPT:
86357; 86359; 86360
Test Includes
Percentage CD3+; absolute CD3+; percentage CD3+CD4+; absolute CD3+CD4+; percentage CD3+CD8+; absolute CD3+CD8+; CD4:CD8 ratio; percentage natural killer (NK) cells; absolute natural killer (NK) cells; CBC
Expected Turnaround Time
1 - 3 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Documents
Specimen Requirements
Specimen
Whole blood
Volume
Fill tube(s) to capacity.
Container
Lavender-top (EDTA) tube and yellow-top (ACD-A or ACD-B) tube
Collection
Invert tube 8 to 10 times immediately after collection. To preserve cellular viability, collect specimen so it will arrive in the laboratory within 48 hours of collection. Indicate date and time of venipuncture on the tube(s) and on the test request form.
Storage Instructions
Maintain specimen at room temperature. Do not freeze or refrigerate.
Stability Requirements
Temperature | Period |
|---|---|
Room temperature | Yellow-top (ACD-A) or (ACD-B) tube: 2 days Lavender-top (EDTA) tube: 1 day |
Refrigerated | Unstable |
Frozen | Unstable |
Freeze/thaw cycles | Unstable |
Causes for Rejection
Hemolysis; specimen refrigerated or frozen; clotted specimen; contaminated specimen
Test Details
Use
This test is used to monitor patients' helper/suppressor T-cell status and assess other changes in T-cell surface markers that may indicate changes in immune status.
Methodology
Flow cytometry
Reference Interval
Reference intervals for adults have been established by the laboratory. See table.
CD | Age | 95% Confidence Interval | |||
|---|---|---|---|---|---|
Percentage | Cells/mm3 | ||||
Minimum | Maximum | Minimum | Maximum | ||
Pediatric reference intervals are from Comans-Bitter WM, de Groot R, van den Beemd R, et al. Immunophenotyping of blood lymphocytes in childhood. Reference values for lymphocyte subpopulations. J Pediatrics. 1997 Mar; 130(3):388-393. | |||||
CD3+ | Neonates | 28 | 76 | 600 | 5000 |
1 wk to 2 m | 60 | 85 | 2300 | 7000 | |
2 to 5 m | 48 | 75 | 2300 | 6500 | |
5 to 9 m | 50 | 77 | 2400 | 6900 | |
9 to 15 m | 54 | 76 | 1600 | 6700 | |
15 to 24 m | 39 | 73 | 1400 | 8000 | |
2 to 5 y | 43 | 76 | 900 | 4500 | |
5 to 10 y | 55 | 78 | 700 | 4200 | |
10 to 16 y | 52 | 78 | 800 | 3500 | |
Adults | 58 | 86 | 622 | 2402 | |
CD3+CD4+ | Neonates | 17 | 52 | 400 | 3500 |
1 wk to 2 m | 41 | 68 | 1700 | 5300 | |
2 to 5 m | 33 | 58 | 1500 | 5000 | |
5 to 9 m | 33 | 58 | 1400 | 5100 | |
9 to 15 m | 31 | 54 | 1000 | 4600 | |
15 to 24 m | 25 | 50 | 900 | 5500 | |
2 to 5 y | 23 | 48 | 500 | 2400 | |
5 to 10 y | 27 | 53 | 300 | 2000 | |
10 to 16 y | 25 | 48 | 400 | 2100 | |
Adults | 31 | 59 | 359 | 1519 | |
CD3+CD8+ | Neonates | 10 | 41 | 200 | 1900 |
1 wk to 2 m | 9 | 23 | 400 | 1700 | |
2 to 5 m | 11 | 25 | 500 | 1600 | |
5 to 9 m | 13 | 26 | 600 | 2200 | |
9 to 15 m | 12 | 28 | 400 | 2100 | |
15 to 24 m | 11 | 32 | 400 | 2300 | |
2 to 5 y | 14 | 33 | 300 | 1600 | |
5 to 10 y | 19 | 34 | 300 | 1800 | |
10 to 16 y | 9 | 35 | 200 | 1200 | |
Adults | 12 | 36 | 109 | 897 | |
T4:T8 ratio | Adults | 0.92 | 3.72 | ||
CD3-CD56+ | Neonates | 6 | 58 | 100 | 1900 |
1 wk to 2 m | 3 | 23 | 200 | 1400 | |
2 to 5 m | 2 | 14 | 100 | 1300 | |
5 to 9 m | 2 | 13 | 100 | 1000 | |
9 to 15 m | 3 | 17 | 200 | 1200 | |
15 to 24 m | 3 | 16 | 100 | 1400 | |
2 to 5 y | 4 | 23 | 100 | 1000 | |
5 to 10 y | 4 | 26 | 90 | 900 | |
10 to 16 y | 6 | 27 | 70 | 1200 | |
Adults | 1 | 19 | 24 | 406 | |
Additional Information
HIV-1 infection results in a decrease of CD4 T cells, an increase in CD8 T cells, a decrease in the CD4:CD8 ratio, and a progressive destruction of immune function. Enumeration of CD4 and CD8 T cells in HIV-1 seropositive patients may be used for prognostic purposes and to monitor disease progression and retroviral therapy. Natural killer (NK) cells are large granular lymphocytes that mediate MHC-unrestricted cytotoxicity against virus-infected and malignant cells and manufacture a number of cytokines following stimulation of the immune system.
References
1997 revised guidelines for performing CD4+ T-cell determinations in persons infected with human immunodeficiency virus (HIV). Centers for Disease Control and Prevention. MMWR Recomm Rep. 1997 Jan 10;46(RR-2):1-29.9011774
Giorgi J, Kesson A, Chou CC. Immunodeficiency and infectious diseases. In: Rose N, deMacario E, Fahey J, et al, eds. Manual of Clinical Laboratory Immunology. 4th ed. Washington, DC: ASM Press;1992:chap 25.
Lanier L, Jackson A. Monoclonal antibodies: Differentiation antigens expressed on leukocytes. In: Rose N, deMacario E, Fahey J, et al, eds. Manual of Clinical Laboratory Immunology. 4th ed. Washington, DC: ASM Press;1992:chap 23.
Stevens RA, Lempicki RA, Natarajan V, et al. General immunologic evaluation of patients with immunodeficiency virus infection. In: Detrick B, Hamilton RG, Folds JD, et al, eds. Manual of Molecular and Clinical Laboratory Immunology. 7th ed. Washington, DC: ASM Press;2006:chap 95.
LOINC® Map
| Order Code | Order Code Name | Order Loinc | Result Code | Result Code Name | UofM | Result LOINC |
|---|---|---|---|---|---|---|
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 506729 | % NK (CD56/16) | % | 8112-5 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 506730 | Ab NK (CD56/16) | /uL | 9728-7 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 059603 | Absolute CD 3 | /uL | 8122-4 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 505010 | Absolute CD 4 Helper | /uL | 24467-3 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 505579 | Abs. CD 8 Suppressor | /uL | 14135-8 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 059618 | % CD 3 Pos. Lymph. | % | 8124-0 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 505009 | % CD 4 Pos. Lymph. | % | 8123-2 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 505580 | % CD 8 Pos. Lymph. | % | 8101-8 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 505273 | CD4/CD8 Ratio | 54218-3 | |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 005025 | WBC | x10E3/uL | 6690-2 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 005033 | RBC | x10E6/uL | 789-8 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 005041 | Hemoglobin | g/dL | 718-7 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 005058 | Hematocrit | % | 4544-3 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 015065 | MCV | fL | 787-2 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 015073 | MCH | pg | 785-6 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 015081 | MCHC | g/dL | 786-4 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 105007 | RDW | % | 788-0 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 015172 | Platelets | x10E3/uL | 777-3 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 015107 | Neutrophils | % | 770-8 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 015123 | Lymphs | % | 736-9 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 015131 | Monocytes | % | 5905-5 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 015149 | Eos | % | 713-8 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 015156 | Basos | % | 706-2 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 115398 | Immature Cells | N/A | |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 015909 | Neutrophils (Absolute) | x10E3/uL | 751-8 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 015917 | Lymphs (Absolute) | x10E3/uL | 731-0 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 015925 | Monocytes(Absolute) | x10E3/uL | 742-7 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 015933 | Eos (Absolute) | x10E3/uL | 711-2 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 015941 | Baso (Absolute) | x10E3/uL | 704-7 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 015108 | Immature Granulocytes | % | 71695-1 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 015911 | Immature Grans (Abs) | x10E3/uL | 53115-2 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 015945 | NRBC | % | 58413-6 |
| 259317 | Helper/Suppress/Natural Killer | 53759-7 | 015180 | Hematology Comments: | 18314-5 |
| Reflex Table for Immature Cells | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 115399 | Immature Cells | 115400 | Bands | % | 35332-6 |
| Reflex Table for Immature Cells | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 115399 | Immature Cells | 115401 | Metamyelocytes | % | 28541-1 |
| Reflex Table for Immature Cells | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 115399 | Immature Cells | 115403 | Myelocytes | % | 26498-6 |
| Reflex Table for Immature Cells | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 115399 | Immature Cells | 115404 | Promyelocytes | % | 26498-6 |
| Reflex Table for Immature Cells | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 115399 | Immature Cells | 115405 | Blasts/blast like cells | % | 26498-6 |
| Reflex Table for Immature Cells | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 115399 | Immature Cells | 115406 | Megakaryocytes | % | 19252-6 |
| Reflex Table for Immature Cells | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 115399 | Immature Cells | 115265 | Other, Lineage Uncertain | % | 55433-7 |
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