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HelpTest Code LAB3271 Lymphocyte Subset Analysis (T&B)
Additional Codes
MULTIPLE ORDER SELECTIONS
Ordering Providers: select desired tests on requisition or in Epic under Order Questions - see table below. For outside requisitions, please be sure to check box for Lymphocyte Subset Analysis AND select appropriate panel(s) in lower box.
| Clinical System Name | Panel Information |
|---|---|
| T and B CD3, CD4 | Lymphocyte Subsets - CD3, CD4 |
| T and B CD3 and Subsets | Lymphocyte Subsets - CD3, CD4, CD8 |
| T and B CD3, CD4, B Cells | Lymphocyte Subsets - CD3, CD4, CD19, CD20 |
| T and B CD3, Subsets, B Cells | Lymphocyte Subsets - CD3, CD4, CD8, CD19, CD20 |
| T and B CD3, Subsets, B Cells, NK Cells | Lymphocyte Subsets - CD3, CD4, CD8, CD16, CD19, CD20, CD56 (Formerly SCCA panel) |
| T and B Full Panel with Natural Killer Cells | Lymphocyte Subsets - Full Panel (Includes: CD2, CD3, CD4, CD8, CD16, CD19, CD56, HLA DR) (Formerly Full Panel - other immunodeficiencies) |
| TCR | TCR-alpha beta and gamma delta (Includes: CD3, TCR alpha/beta, TCR gamma/delta) |
| T and B Full Panel no Natural Killer Cells | Lymphocyte Subsets - HIV Panel (Includes: CD2, CD3, CD4, CD8, CD19, HLA DR) |
| CD45 RA RO | CD45 RA RO (Includes: CD3, CD4, CD8, CD45 RA/RO) |
| ALPS Screen |
ALPS screen (includes: TCR alpha/beta positive, double negative T cells). CD3, CD4, CD8 are run as part of ALPS testing but results are not reported separately. If CD3, CD4, CD8 results are needed, additional box(s) needs to be selected under order questions. |
| Leukocyte Adhesion Defect Full Panel | Leukocyte Adhesion Defect Full Panel (Includes: CD11a, CD11b, CD11c, CD18) |
| Leukocyte Adhesion Study CD18 Only | Leukocyte Adhesion Study (Includes: CD18 only) |
The minimum panel available includes CD4 and CD3. Panels can be ordered alone, or in combination with other T and B Panels - duplicate tests will not be charged.
TCR, ALPS, CD45 RA RO, Leukocyte Adhesion Workup - Are all ordered under Lymphocyte Subset Analysis in EPIC.
Clinical System Name
Lymphocyte Subset Analysis
Synonyms
T&B; Immunodeficiency Panel;
Sample Requirements
Specimen: Whole Blood
Container(s): Lavender/EDTA; Dark Green/Sodium Heparin also acceptable from referring labs if CBC & differential results submitted. Microtainers not recommended. Capillary samples will be rejected!
Preferred Vol: 2.0 - 3.0 mL
Minimum Vol: 1.0 mL total in single tube
Note: T&B SHOULD SHARE one lavender tube with CBC Diff (if ordered). Specimens received after 1430 will be held and testing will be performed the next working day.
| Collected in-house at Seattle Children's | Collected off-site (including SCH Bellevue, SCH North and SCH South) | |
|---|---|---|
| M-Th | collect any time | collect any time |
| Friday | collect any time | ok if received at SCH main lab same day, if not do not collect |
| Saturday | ok if collected before 12 noon | do not collect |
| day before a holiday | ok if collected before 12 noon | must be received at SCH main lab before 12 noon |
| Sunday | ok if collected after 12 noon (to be tested next morning) |
ok if collected after 12 noon (to be tested next morning) |
| Sunday before a holiday Monday | do not collect | do not collect |
| Holiday | ok if collected after 12 noon (to be tested next morning) | ok if collected after 12 noon (to be tested next morning) |
Children's Outpatient Blood Draw areas and Community Services - order "Lymphocyte Subset" and select Paper Requisition under order comments (specific tests will be ordered in Cell Markers Lab) and submit copy of requisition with specimen.
Processing Instructions
Reject due to: clotted specimen, capillary collection, refrigerated
Spin: N
Aliquot: N
Temp: RT
Note: Have Core Lab perform a CBC with differential and send a copy of the results and requisition with specimen to Cell Markers.
Storage location:
Days: Transport specimen, copy of community services requisition (if applicable), and labels to Cell Markers (tube station #181).
Eves/Nights: Store specimen, copy of community services requisition (if applicable), and labels in the Cell Markers RT box in CPA.
Off-site collection: Keep whole blood at room temperature. Referring labs may send CBC w/differential results from the same collection along with the sample.
Stability
| Temperature | Time |
|---|---|
| Room temp |
EDTA - 30 h Heparin - 48 h |
| Refrigerated | N |
| Frozen | N |
Availability
| STAT | Performed | TAT |
|---|---|---|
| N | M-F, S (0730-1200) | 2 - 3 d |
Note: limited specimen stability - see Sample Requirements for details.
Performing Laboratory
Seattle Children's Laboratory
Department
Department: Cell Markers
Phone Number: (206) 987-2617 (Lab Client Services)
CPT Codes
| LYMPHOCYTE SUBSET ANALYSIS (T&B) PANELS | CPT CODE(S) |
|---|---|
| Full Panel with Natural Killers (CD2, CD3, CD4, CD8, CD16, CD19, CD56, HLA DR) | |
| CM AB IF Total T Cells | 86359 |
| CM AB IF CD4/8 | 86360 |
| CD3/19/45 DIR IF Stain/Run/Analyze (B cells) | 86355 |
| CD3/16/45 DIR IF Stain/Run/Analyze (NK Cells) | 86357 |
| CM AB IF HLA-DR | 86356 |
| Full Panel without Natural Killers (CD2, CD3, CD4, CD8, CD19, HLADR | |
| CM AB IF Total T Cells | 86359 |
| CM AB IF CD4/8 | 86360 |
| CD3/19/45 DIR IF Stain/Run/Analyze (B Cells) | 86355 |
| CM AB IF HLA-DR | 86356 |
| B Cells (CD3, CD4, CD19, CD20) | |
| CM AB IF Total T Cells | 86359 |
| CD3/4/45 DIR IFStain/Run/Analysis | 86361 |
| CD3/19/45 DIR IFStain/Run/Analysis (B Cells) | 86355 |
| CD3 & Subsets | |
| CM AB IF Total T Cells CD3 | 86359 |
| CM AB IF CD4/8 | 86360 |
| CD3/CD4 only | |
| CM AB IF Total T Cells CD3 | 86359 |
| CD3/4/45 DIR IFStain/Run/Analysis | 86361 |
| *the minimum panel available includes CD3 & CD4 |
For additional information, please contact Laboratory Client Services at 206-987-2617.
Methodology
Method: Flow Cytometry
Analytical Volume: Dependent on patient's white count and testing requested. If <1mL is collected please ask to recollect in order to obtain minimum volume of 1mL. If unable to recollect and sample volume is <0.350mL (350uL) please cancel and do not send to Cell Markers for testing. If unable to recollect and sample is between 0.350mL and 1mL (350ul-1mL) please send to Cell Markers, but let patient and/or patient family know that there is a strong possibility that we will not be able to perform the testing due to low volume. We will do our best and understand that the volume needed is dependent on the white count and the specific antibodies that are ordered. (The higher the white count the less volume needed. The more antibodies ordered the more volume needed.)
Limitations: refrigeration selectively decreases subsets - refrigerated samples not acceptable.
Reference Range
Reference values accompany patient report.
Description
This group of assays are used for enumerating the percentages and absolute cell counts for lymphocyte subsets in whole blood. The tests are used in the evaluation of immune function, in the setting of primary and secondary immune deficiencies, post-transplant, and monitoring monoclonal antibody therapies.
Note: 'B cell phenotyping' and 'T cell phenotyping' are separate tests performed in Cell Markers (B cell phenotyping) and sent out to Mayo Medical Laboratories in Rochester (T cell phenotyping) - see separate listings for details