T- and B-Lymphocyte and Natural Killer Cell Profile

TEST: 505370
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CPT: 86355; 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+; percentage CD3-CD56+ natural killer (NK) cells; absolute CD3-CD56+ natural killer (NK) cells; percentage CD19+; absolute CD19+; CD4:CD8 ratio; 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.

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

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

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

645

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

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.
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
505370 T- and B-Lymphocyte/Nat Killer 65758-5 059478 Abs.CD19+ Lymphs /uL 8116-6
505370 T- and B-Lymphocyte/Nat Killer 65758-5 059501 % CD19+ Lymphs % 8117-4
505370 T- and B-Lymphocyte/Nat Killer 65758-5 059525 Absolute CD 3 /uL 8122-4
505370 T- and B-Lymphocyte/Nat Killer 65758-5 059527 % CD 3 Pos. Lymph. % 8124-0
505370 T- and B-Lymphocyte/Nat Killer 65758-5 059526 Absolute CD 4 Helper /uL 24467-3
505370 T- and B-Lymphocyte/Nat Killer 65758-5 059543 % CD 4 Pos. Lymph. % 8123-2
505370 T- and B-Lymphocyte/Nat Killer 65758-5 059551 Abs. CD 8 Suppressor /uL 14135-8
505370 T- and B-Lymphocyte/Nat Killer 65758-5 059568 % CD 8 Pos. Lymph. % 8101-8
505370 T- and B-Lymphocyte/Nat Killer 65758-5 059576 CD4/CD8 Ratio 54218-3
505370 T- and B-Lymphocyte/Nat Killer 65758-5 506730 Ab NK (CD56/16) /uL 9728-7
505370 T- and B-Lymphocyte/Nat Killer 65758-5 506729 % NK (CD56/16) % 8112-5
505370 T- and B-Lymphocyte/Nat Killer 65758-5 005025 WBC x10E3/uL 6690-2
505370 T- and B-Lymphocyte/Nat Killer 65758-5 005033 RBC x10E6/uL 789-8
505370 T- and B-Lymphocyte/Nat Killer 65758-5 005041 Hemoglobin g/dL 718-7
505370 T- and B-Lymphocyte/Nat Killer 65758-5 005058 Hematocrit % 4544-3
505370 T- and B-Lymphocyte/Nat Killer 65758-5 015065 MCV fL 787-2
505370 T- and B-Lymphocyte/Nat Killer 65758-5 015073 MCH pg 785-6
505370 T- and B-Lymphocyte/Nat Killer 65758-5 015081 MCHC g/dL 786-4
505370 T- and B-Lymphocyte/Nat Killer 65758-5 105007 RDW % 788-0
505370 T- and B-Lymphocyte/Nat Killer 65758-5 015172 Platelets x10E3/uL 777-3
505370 T- and B-Lymphocyte/Nat Killer 65758-5 015107 Neutrophils % 770-8
505370 T- and B-Lymphocyte/Nat Killer 65758-5 015123 Lymphs % 736-9
505370 T- and B-Lymphocyte/Nat Killer 65758-5 015131 Monocytes % 5905-5
505370 T- and B-Lymphocyte/Nat Killer 65758-5 015149 Eos % 713-8
505370 T- and B-Lymphocyte/Nat Killer 65758-5 015156 Basos % 706-2
505370 T- and B-Lymphocyte/Nat Killer 65758-5 115398 Immature Cells N/A
505370 T- and B-Lymphocyte/Nat Killer 65758-5 015909 Neutrophils (Absolute) x10E3/uL 751-8
505370 T- and B-Lymphocyte/Nat Killer 65758-5 015917 Lymphs (Absolute) x10E3/uL 731-0
505370 T- and B-Lymphocyte/Nat Killer 65758-5 015925 Monocytes(Absolute) x10E3/uL 742-7
505370 T- and B-Lymphocyte/Nat Killer 65758-5 015933 Eos (Absolute) x10E3/uL 711-2
505370 T- and B-Lymphocyte/Nat Killer 65758-5 015941 Baso (Absolute) x10E3/uL 704-7
505370 T- and B-Lymphocyte/Nat Killer 65758-5 015108 Immature Granulocytes % 71695-1
505370 T- and B-Lymphocyte/Nat Killer 65758-5 015911 Immature Grans (Abs) x10E3/uL 53115-2
505370 T- and B-Lymphocyte/Nat Killer 65758-5 015945 NRBC % 58413-6
505370 T- and B-Lymphocyte/Nat Killer 65758-5 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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