T- and B-Lymphocyte Differential Profile

T- and B-Lymphocyte Differential Profile

Number

096917

CPT

86355; 86359; 86360

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

Specimen

Whole blood

Volume

7 mL EDTA whole blood and 7 mL ACD-A whole blood

Container

Lavender-top (EDTA) tube and yellow-top (ACD-A) tube

Collection

To preserve cellular viability, collect specimen so it will arrive in the laboratory Monday through Friday and within 24 hours of collection. Please indicate date and time of venipuncture on the tube(s) and on the request form.

Storage Instructions

Maintain specimen at room temperature. Do not freeze or refrigerate.

Causes for Rejection

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

Reference Interval

Reference intervals for adults have been established by the laboratory. See table. Reference Intervals for Lymphocyte Immunophenotyping

CD	Age	95% Confidence Interval
		Percentage		Cells/mm³
		Minimum	Maximum	Minimum	Maximum
CD3⁺	Neonates	28	76	600	5000
	1 wk - 2 mo	60	85	2300	7000
	2-5 mo	48	75	2300	6500
	5-9 mo	50	77	2400	6900
	9-15 mo	54	76	1600	6700
	15-24 mo	39	73	1400	8000
	2-5 y	43	76	900	4500
	5-10 y	55	78	700	4200
	10-16 y	52	78	800	3500
	Adults	58	86	622	2402
CD3⁺CD4⁺	Neonates	17	52	400	3500
	1 wk - 2 mo	41	68	1700	5300
	2-5 mo	33	58	1500	5000
	5-9 mo	33	58	1400	5100
	9-15 mo	31	54	1000	4600
	15-24 mo	25	50	900	5500
	2-5 y	23	48	500	2400
	5-10 y	27	53	300	2000
	10-16 y	25	48	400	2100
	Adults	31	59	359	1519
CD3⁺CD8⁺	Neonates	10	41	200	1900
	1 wk - 2 mo	9	23	400	1700
	2-5 mo	11	25	500	1600
	5-9 mo	13	26	600	2200
	9-15 mo	12	28	400	2100
	15-24 mo	11	32	400	2300
	2-5 y	14	33	300	1600
	5-10 y	19	34	300	1800
	10-16 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 - 2 mo	4	26	600	1900
	2-5 mo	14	39	600	3000
	5-9 mo	13	35	700	2500
	9-15 mo	15	39	600	2700
	15-24 mo	17	41	600	3100
	2-5 y	14	44	200	2100
	5-10 y	10	31	200	1600
	10-16 y	8	24	200	600
	Adults	3	25	12	640
Pediatric reference intervals are from Comans-Bitter WM, et al, “Immunophenotyping of Blood Lymphocytes in Childhood,” J Pediatrics, 1997, 130:388-93.

Use

Enumeration of lymphocyte subsets for classification and diagnosis of primary immunodeficiency diseases and for evaluating and monitoring AIDS patients

Methodology

Flow cytometry

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.

References

Giorgi J, Kesson A, and Chou CC, “Immunodeficiency and Infectious Diseases,” Manual of Clinical Laboratory Immunology, 4th ed, Chapter 25, Rose N, deMacario E, Fahey J, et al, eds, Washington, DC: ASM Press, 1992.

Stevens RA, Lempicki RA, Natarajan V, et al, “General Immunologic Evaluation of Patients With Immunodeficiency Virus Infection,” Manual of Molecular and Clinical Laboratory Immunology, 7th ed, Chapter 95, Detrick B, Hamilton RG, and Folds JD, et al, eds, Washington, DC: ASM Press, 2006.

“The 1997 Guidelines for Performing CD4⁺ T-Cell Determinations in Persons Infected With Human Immunodeficiency Virus (HIV),” MMWR, 1997, 46:RR-2.