Test Code TBBS Quantitative Lymphocyte Subsets: T, B, and Natural Killer (NK) Cells, Blood
Additional Codes
CNE Order Code: T+B Cell QN
Reporting Name
QN Lymphocyte Subsets: T, B, and NKUseful 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
Performing Laboratory
Mayo Clinic Laboratories in RochesterSpecimen 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 |
Reference Values
The appropriate age-related reference values will be provided on the report.
Day(s) Performed
Monday through Sunday
CPT Code Information
86355
86357
86359
86360
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
TBBS | QN Lymphocyte Subsets: T, B, and NK | 80721-4 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
3321 | CD45 Total Lymph Count | 27071-0 |
3316 | % CD3 (T Cells) | 8124-0 |
3322 | CD3 (T Cells) | 8122-4 |
3319 | % CD4 (T Cells) | 8123-2 |
3325 | CD4 (T Cells) | 24467-3 |
3320 | % CD8 (T Cells) | 8101-8 |
3326 | CD8 (T Cells) | 14135-8 |
3318 | % CD19 (B Cells) | 8117-4 |
3324 | CD19 (B Cells) | 8116-6 |
4054 | % CD16+CD56 (NK cells) | 8112-5 |
4055 | CD16+CD56 (NK cells) | 20402-4 |
3327 | 4/8 Ratio | 54218-3 |
6657 | Comment | 80722-2 |
Interpretation
HIV treatment guidelines from the US Department of Health and Human Services and the International Antiviral Society-USA Panel recommend antiviral treatment in all patients with HIV infection, regardless of CD4 T-cell count.(10,11) Additionally, antibiotic prophylaxis for Pneumocystis jiroveci infection is recommended for patients with CD4 count less than 200 cells/mcL. For other opportunistic infections, see the recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America.(12)
Report Available
Same day/1 to 2 daysReject Due To
Gross hemolysis | Reject |
Gross lipemia | Reject |
Method Name
Flow Cytometry
Testing Algorithm
For information see Newborn Screen Follow-up for Severe Combined Immunodeficiency Syndrome (SCID).
Special Instructions
T&B Cells by Flow Cytometry, Blood