Helper/Suppressor and Natural Killer Cell Profile

CPT: 86357; 86359; 86360
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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


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

2 days

Refrigerated

Unstable

Frozen

Unstable

Freeze/thaw cycles

Unstable


Causes for Rejection

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


Test Details


Use

Monitor patients helper/suppressor T-cell status; 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.

Reference Intervals for Lymphocyte Immunophenotyping

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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