Lymphocyte Subset Panel 6 - Total Lymphocyte Enumeration with CD45RA and CD45RO
0095862
 
Time SensitiveTime Sensitive
Ordering Recommendation
Useful for assessing primary T-cell immunodeficiency disorders.
Mnemonic
TEXTENDED
Methodology
Quantitative Flow Cytometry
Performed
Sun-Sat
Reported
1-3 days
New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation
 
Collect
Lavender Hemogard (EDTA), pink Hemogard (K2EDTA), or green Hemogard (sodium or lithium heparin). Hemogard tubes are preferred for laboratory safety.  
Specimen Preparation
Transport 4 mL whole blood. (Min: 0.5 mL)  
Storage/Transport Temperature
CRITICAL ROOM TEMPERATURE.  
Unacceptable Conditions
Frozen or refrigerated specimens. Specimens older than 72 hours in EDTA or 48 hours in heparin. Clotted or hemolyzed specimens.
New York State Clients:
Specimens collected in heparin. Frozen or refrigerated specimens. EDTA specimens older than 30 hours. Clotted or hemolyzed specimens.  
Remarks
Specimens must be analyzed within 72 hours of collection in EDTA or within 48 hours in heparin. Some medications may affect immunophenotyping results and should be listed on the patient test request form.
New York State Clients:
Only EDTA specimens may be submitted and must be analyzed within 30 hours of collection.  
Stability
Ambient: 72 hours in EDTA, 48 hours in heparin; Refrigerated: Unacceptable; Frozen: Unacceptable
New York State Clients:
EDTA: Ambient: 30 hours; Refrigerated: Unacceptable; Frozen: Unacceptable  
Reference Interval
Effective November 18, 2013
Reports include age appropriate reference intervals and interpretation.
Components Age: 0-​11 months Age: 12-​23 months Age: 2 years and older
% CD3 (Total T-​cells) 58-​85 % 53-​81 % 62-​87 %
Absolute CD3 2170-​6500 cells/µL 1460-​5440 cells/µL 570-​2400 cells/µL
% CD4 (Helper T-​cells) 38-​62 % 31-​54 % 32-​64 %
Absolute CD4 1580-​4850 cells/µL 1020-​3600 cells/µL 430-​1800 cells/µL
% CD45RA (Naive helper T-​cells) 15-​70 % 15-​70 % 5-​37 %
Absolute CD45RA 200-​3400 cells/µL 200-​3400 cells/µL 130-​1100 cells/µL
% CD45RO (Memory helper T-​cells) 5-​30 % 5-​30 % 12-​38 %
% CD45RO (Memory helper T-​cells) 50-​1500 cells/µL 50-​1500 cells/µL 220-​1000 cells/µL
% CD8 (Suppressor T-​cells) 16-​34 % 16-​38 % 15-​46 %
Absolute CD8 680-​2470 cells/µL 570-​2230 cells/µL 210-​1200 cells/µL
CD4:CD8 ratio 1.17-​6.62 1.17-​6.62 0.80-​3.90
% CD19 (B-​cells ) 11-​45 % 11-​45 % 6-​23 %
Absolute CD19 430-​3300 cells/µL 430-​3300 cells/µL 91-​610 cells/µL
% NK-​cells 3-​19 % 3-​19 % 4-​26 %
Absolute NK-​cells 80-​340 cells/µL 80-​340 cells/µL 78-​470 cells/µL
Interpretive Data
The CD4 cells are Helper T-cells expressing both CD3 and CD4. The CD8 cells are Cytotoxic T-cells expressing both CD3 and CD8. The B-cells express CD19 but not CD3. The NK-cells express either CD16 or CD56 (or both) but not CD3. The CD45RA cells express both CD4 and CD45RA and the CD45RO cells express both CD4 and CD45RO. CD4 T-cell levels are a criterion for categorizing HIV-related clinical conditions by the CDC's classification system for HIV infection. The measurement of CD4 T-cell levels has been used to establish decision points for initiating P. jiroveci prophylaxis, antiviral therapy and to monitor the efficacy of treatment. The Public Health Service (PHS) has recommended that CD4 T-cell levels be monitored every three to six months in all HIV-infected persons.

The performance characteristics of this test were determined by ARUP Laboratories, Inc.

See Compliance Statement A: www.aruplab.com/CS
Note
This test is designed for enumerating the percents and absolute cell counts of lymphocyte subsets in lysed whole blood. Whole blood is added to fluorochrome-labeled antibodies that bind specifically to cell surface antigens on lymphocytes. After incubation, lysing and fixation, percents and absolute counts are enumerated utilizing an internal quantitation standard. Additional CBC data is not required.

During HIV infection, antiviral therapy is often initiated when the absolute CD4 count drops below 500 cells/µL. When the absolute CD4 count drops below 200 cells/µL, therapeutic prophylaxis against PCP and other opportunistic infections may be initiated. When the absolute CD4 count drops below 100 cells/µL, prophylaxis against Mycobacterium avium complex is recommended.

The CD45RA subset delineates a "naive" CD4 T-cell population. The CD45RO subset delineates a "memory" CD4 T-cell population. With disease progression in HIV-infected individuals, a decrease in CD45RA "naive" cells may be observed.

For longitudinal studies involving serial monitoring, specimen collections should be performed at the same time of day.
CPT Code(s)
86355; 86357; 86359; 86360; 86356 x2
Components
Component Test Code*Component Chart Name
0095617Lymphocyte Subset Panel 6 Information
0095700Absolute CD19
0095701% Natural Killer Cells
0095702Absolute Natural Killer Cells
0095751Absolute CD45RO
0095752% CD45RO
0095816Absolute CD45RA
0095827% CD45RA
0095902Absolute CD3
0095903% CD3
0095905% CD4
0095906Absolute CD4
0095910% CD8
0095911Absolute CD8
0095914% CD19
0095920CD4:CD8 Ratio
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, contact interface support at interface.support@aruplab.com.
Cross References
  • T-Cell Immunodeficiency Extended Profile