096917: T- and B-Lymphocyte Differential Profile

Test Details

Methodology

Flow cytometry

Result 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.

Test Includes

Percentage CD3⁺; absolute CD3⁺ (T cells); percentage CD3⁺CD4⁺; absolute CD3⁺CD4⁺ (helper/inducer); percentage CD3⁺CD8⁺; absolute CD3⁺CD8⁺ (suppressor/cytotoxic); percentage CD19⁺; absolute CD19⁺ (B cells); CD4:CD8 ratio; absolute lymphocyte count; CBC with differential and platelet count

Use

This test is used for enumeration of lymphocyte subsets for classification and diagnosis of primary immunodeficiency diseases and for evaluating and monitoring AIDS patients.

Custom Additional Information

Primary immunodeficiencies result from congenital defects of the immune system. Acquired immunodeficiency syndrome (AIDS) results from infection with the HIV-1 retrovirus. The purpose of flow cytometric enumeration is to determine whether select lymphocyte subsets are reduced or absent in order to support the diagnosis of numeric cellular immunodeficiency rather than immunodeficiency due to cellular dysfunction.

HIV-1 infection results in a decrease of CD4 T cells, an increase of CD8 T cells, a decrease in the CD4:CD8 ratio, and a progressive destruction of immune function. In HIV-1 seropositive patients, enumeration of CD4 T cells may be used for prognostic purposes and to monitor disease progression and antiretroviral therapy.

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 Instructions

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.

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

Reference Range

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
CD19⁺	Neonates	5	22	40	1100
	1 wk to 2 m	4	26	600	1900
	2 to 5 m	14	39	600	3000
	5 to 9 m	13	35	700	2500
	9 to 15 m	15	39	600	2700
	15 to 24 m	17	41	600	3100
	2 to 5 y	14	44	200	2100
	5 to 10 y	10	31	200	1600
	10 to 16 y	8	24	200	600
	Adults	3	25	12	640

Storage Instructions

Maintain specimen at room temperature.

Causes for Rejection

Hemolysis; specimen refrigerated or frozen; clotted specimen; contaminated specimen

References

Centers for Disease Control and Prevention (CDC). 1997 revised guidelines for performing CD4+ T-cell determinations in persons infected with human immunodeficiency virus (HIV).MMWR. 1997 Jan 10; 46:RR-2.

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.

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
096917	T + B-Lymphocyte Differential	65759-3	059478	Abs.CD19+ Lymphs	/uL	8116-6
096917	T + B-Lymphocyte Differential	65759-3	059525	Absolute CD 3	/uL	8122-4
096917	T + B-Lymphocyte Differential	65759-3	059526	Absolute CD 4 Helper	/uL	24467-3
096917	T + B-Lymphocyte Differential	65759-3	059551	Abs. CD 8 Suppressor	/uL	14135-8
096917	T + B-Lymphocyte Differential	65759-3	059501	% CD19+ Lymphs	%	8117-4
096917	T + B-Lymphocyte Differential	65759-3	059527	% CD 3 Pos. Lymph.	%	8124-0
096917	T + B-Lymphocyte Differential	65759-3	059543	% CD 4 Pos. Lymph.	%	8123-2
096917	T + B-Lymphocyte Differential	65759-3	059568	% CD 8 Pos. Lymph.	%	8101-8
096917	T + B-Lymphocyte Differential	65759-3	059576	CD4/CD8 Ratio		54218-3
096917	T + B-Lymphocyte Differential	65759-3	005025	WBC	x10E3/uL	6690-2
096917	T + B-Lymphocyte Differential	65759-3	005033	RBC	x10E6/uL	789-8
096917	T + B-Lymphocyte Differential	65759-3	005041	Hemoglobin	g/dL	718-7
096917	T + B-Lymphocyte Differential	65759-3	005058	Hematocrit	%	4544-3
096917	T + B-Lymphocyte Differential	65759-3	015065	MCV	fL	787-2
096917	T + B-Lymphocyte Differential	65759-3	015073	MCH	pg	785-6
096917	T + B-Lymphocyte Differential	65759-3	015081	MCHC	g/dL	786-4
096917	T + B-Lymphocyte Differential	65759-3	105007	RDW	%	788-0
096917	T + B-Lymphocyte Differential	65759-3	015172	Platelets	x10E3/uL	777-3
096917	T + B-Lymphocyte Differential	65759-3	015107	Neutrophils	%	770-8
096917	T + B-Lymphocyte Differential	65759-3	015123	Lymphs	%	736-9
096917	T + B-Lymphocyte Differential	65759-3	015131	Monocytes	%	5905-5
096917	T + B-Lymphocyte Differential	65759-3	015149	Eos	%	713-8
096917	T + B-Lymphocyte Differential	65759-3	015156	Basos	%	706-2
096917	T + B-Lymphocyte Differential	65759-3	115398	Immature Cells		N/A
096917	T + B-Lymphocyte Differential	65759-3	015909	Neutrophils (Absolute)	x10E3/uL	751-8
096917	T + B-Lymphocyte Differential	65759-3	015917	Lymphs (Absolute)	x10E3/uL	731-0
096917	T + B-Lymphocyte Differential	65759-3	015925	Monocytes(Absolute)	x10E3/uL	742-7
096917	T + B-Lymphocyte Differential	65759-3	015933	Eos (Absolute)	x10E3/uL	711-2
096917	T + B-Lymphocyte Differential	65759-3	015941	Baso (Absolute)	x10E3/uL	704-7
096917	T + B-Lymphocyte Differential	65759-3	015108	Immature Granulocytes	%	71695-1
096917	T + B-Lymphocyte Differential	65759-3	015911	Immature Grans (Abs)	x10E3/uL	53115-2
096917	T + B-Lymphocyte Differential	65759-3	015945	NRBC	%	58413-6
096917	T + B-Lymphocyte Differential	65759-3	015180	Hematology Comments:		18314-5
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	059478
Result Code Name	Abs.CD19+ Lymphs
UofM	/uL
Result LOINC	8116-6
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	059525
Result Code Name	Absolute CD 3
UofM	/uL
Result LOINC	8122-4
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	059526
Result Code Name	Absolute CD 4 Helper
UofM	/uL
Result LOINC	24467-3
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	059551
Result Code Name	Abs. CD 8 Suppressor
UofM	/uL
Result LOINC	14135-8
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	059501
Result Code Name	% CD19+ Lymphs
UofM	%
Result LOINC	8117-4
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	059527
Result Code Name	% CD 3 Pos. Lymph.
UofM	%
Result LOINC	8124-0
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	059543
Result Code Name	% CD 4 Pos. Lymph.
UofM	%
Result LOINC	8123-2
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	059568
Result Code Name	% CD 8 Pos. Lymph.
UofM	%
Result LOINC	8101-8
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	059576
Result Code Name	CD4/CD8 Ratio
UofM
Result LOINC	54218-3
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	005025
Result Code Name	WBC
UofM	x10E3/uL
Result LOINC	6690-2
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	005033
Result Code Name	RBC
UofM	x10E6/uL
Result LOINC	789-8
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	005041
Result Code Name	Hemoglobin
UofM	g/dL
Result LOINC	718-7
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	005058
Result Code Name	Hematocrit
UofM	%
Result LOINC	4544-3
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	015065
Result Code Name	MCV
UofM	fL
Result LOINC	787-2
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	015073
Result Code Name	MCH
UofM	pg
Result LOINC	785-6
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	015081
Result Code Name	MCHC
UofM	g/dL
Result LOINC	786-4
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	105007
Result Code Name	RDW
UofM	%
Result LOINC	788-0
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	015172
Result Code Name	Platelets
UofM	x10E3/uL
Result LOINC	777-3
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	015107
Result Code Name	Neutrophils
UofM	%
Result LOINC	770-8
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	015123
Result Code Name	Lymphs
UofM	%
Result LOINC	736-9
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	015131
Result Code Name	Monocytes
UofM	%
Result LOINC	5905-5
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	015149
Result Code Name	Eos
UofM	%
Result LOINC	713-8
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	015156
Result Code Name	Basos
UofM	%
Result LOINC	706-2
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	115398
Result Code Name	Immature Cells
UofM
Result LOINC	N/A
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	015909
Result Code Name	Neutrophils (Absolute)
UofM	x10E3/uL
Result LOINC	751-8
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	015917
Result Code Name	Lymphs (Absolute)
UofM	x10E3/uL
Result LOINC	731-0
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	015925
Result Code Name	Monocytes(Absolute)
UofM	x10E3/uL
Result LOINC	742-7
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	015933
Result Code Name	Eos (Absolute)
UofM	x10E3/uL
Result LOINC	711-2
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	015941
Result Code Name	Baso (Absolute)
UofM	x10E3/uL
Result LOINC	704-7
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	015108
Result Code Name	Immature Granulocytes
UofM	%
Result LOINC	71695-1
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	015911
Result Code Name	Immature Grans (Abs)
UofM	x10E3/uL
Result LOINC	53115-2
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	015945
Result Code Name	NRBC
UofM	%
Result LOINC	58413-6
Order Code	096917
Order Code Name	T + B-Lymphocyte Differential
Order Loinc	65759-3
Result Code	015180
Result Code Name	Hematology Comments:
UofM
Result LOINC	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 1
Order Code	115399
Order Name	Immature Cells
Result Code	115400
Result Name	Bands
UofM	%
Result LOINC	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 1
Order Code	115399
Order Name	Immature Cells
Result Code	115401
Result Name	Metamyelocytes
UofM	%
Result LOINC	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 1
Order Code	115399
Order Name	Immature Cells
Result Code	115403
Result Name	Myelocytes
UofM	%
Result LOINC	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 1
Order Code	115399
Order Name	Immature Cells
Result Code	115404
Result Name	Promyelocytes
UofM	%
Result LOINC	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 1
Order Code	115399
Order Name	Immature Cells
Result Code	115405
Result Name	Blasts/blast like cells
UofM	%
Result LOINC	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 1
Order Code	115399
Order Name	Immature Cells
Result Code	115406
Result Name	Megakaryocytes
UofM	%
Result LOINC	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
Reflex 1
Order Code	115399
Order Name	Immature Cells
Result Code	115265
Result Name	Other, Lineage Uncertain
UofM	%
Result LOINC	55433-7

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