Order Code LABTBBS Quantitative Lymphocyte Subsets: T, B, and Natural Killer (NK) Cells, Blood
Additional Codes
Mayo Test ID |
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TBBS |
Reporting Name
QN Lymphocyte Subsets: T, B, and NK **It is recommended that specimens arrive within 24 hours of draw. Draw and package specimen as close to shipping time as possible.
Purple top EDTA in original tube
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
Specimen Type
Whole Blood EDTAOrdering 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.
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.
Performing Laboratory
Mayo Clinic Laboratories in RochesterDay(s) Performed
Monday through Sunday
Method Name
Flow Cytometry
CPT Code Information
86355
86357
86359
86360
Method Description
The T-, B-, and natural killer (NK)-cell surface marker assay uses monoclonal antibodies to identify the various membrane antigens, and flow cytometry to enumerate the number of cells expressing these differentiation antigens. CD14 is used to exclude monocytes, thereby improving accuracy and enhancing the purity of the lymphocyte population. The results are reported as the percent of lymphocytes that are total T cells (CD3+), CD3+CD4+ T cells, CD3+CD8+ T cells, natural killer (CD16+56+, CD3-), and B-lymphocytes (CD19+), and the absolute number of each cell type per mL of blood. The assay is a 7-color no-wash procedure, and the absolute counts are calculated from internal bead standards. In addition, the total lymphocyte count and CD4:CD8 ratio are reported.(Hoffman RA, Kung PC, Hansen WP, Goedstien G. Simple and rapid measurement of human T lymphocytes and their subclasses in peripheral blood. Proc Natl Acad Sci USA. 1980:77(8):4914-4917; Mandy FF, Nicholson JK, McDougal JS; CDC. Guidelines for performing single-platform absolute CD4+ T-cell determinations with CD45 gating for persons infected with human immunodeficiency virus. Centers for Disease Control and Prevention. MMWR Recomm Rep. 2003;52(RR-2):1-13)
Testing Algorithm
For information see Newborn Screen Follow-up for Severe Combined Immunodeficiency Syndrome (SCID).