Turnaround times
The quoted turnaround time is from sample receipt in the laboratory, to results authorisation in the Laboratory Information Management system. The times do not include transport of specimen to the laboratory or the administrative process to print and post/email reports. Service users must allow for transport and reporting time when ordering tests.
Clinical background:
Lymphocyte surface markers (subsets) are used primarily in the diagnosis and monitoring of immunodeficiency post treatment (e.g. HSCT) and monitoring of immunotherapeutic agent treatment, such as rituximab.
Abnormal results may also be seen in lymphoma, malignancy, chronic fatigue syndrome and protein-losing enteropathy. Long term immunosuppression can also lead to a generalised reduction in all subsets.
If primary immunodeficiency (PID) is suspected, please discuss with the appropriate Immunologist (adult or paediatric). SCID is profound deficiency of T and/or B cells, which although rare, is fatal if untreated.
The test uses flow cytometry to measure percentages and absolute numbers of lymphocytes, CD3+ T cells, CD4+ cells, CD8+ cells, B cells and NK cells.
Specimen container paediatric:
Whole blood-EDTA
Specimen container adult:
Whole blood-EDTA
Minimum volume paediatric:
0.5 ml
Minimum volume adult:
4 ml
Special requirements:
Samples must always be stored at room temperature and must reach lab by 3pm on Friday.
A FBC taken at the same time (separate sample) is desirable for QC purposes.
Freq analysis:
Daily
Add on test:
Use the contact details below to discuss if an add-on is required
Reference ranges:
| Age range | Neonatal (cells/ul) | 1 wk – 9 months (cells/ul) | 9 – 24 months (cells/ul) | 2 – 5 years (cells/ul) | 5 – 10 years (cells/ul) | 10 – 16 years (cells/ul) | Adult (cells/ul) |
| CD3+ T cells | 600 – 5000 | 2300 – 7000 | 1400 – 8000 | 900 – 4500 | 700 – 4200 | 800 – 3500 | 690 – 2540 |
| CD19+ B cells | 40 – 1100 | 600 – 3000 | 600 – 3100 | 200 – 2100 | 200 – 1600 | 200 – 600 | 90 – 660 |
| CD4+ T cells | 400 – 3500 | 1400 – 5300 | 900 – 5500 | 500 – 2400 | 300 – 2000 | 400 – 2100 | 410 – 1590 |
| CD8+ T cells | 200 – 1900 | 400 – 2200 | 400 – 2300 | 300 – 1600 | 300 – 1800 | 200 – 1200 | 190 – 1140 |
| CD16/ CD56+ NK cells | 100 – 1900 | 100 – 1400 | 100 – 1400 | 100 – 1000 | 90 – 900 | 70 – 1200 | 90 – 590 |
| CD4/CD8 Ratio | 1.0 – 2.6 | 1.3 – 6.3 | 0.9 – 3.9 | 0.9 – 2.9 | 0.9 – 2.6 | 0.9 – 3.4 | 1.0 – 3.6 |
Other info:
Additional markers may be required and added on depending on clinical details and results.
Standard lymphocyte subsets | T, B, NK, CD4, CD8 cells and HLA DR |
CD4 monitoring | T, CD4, CD8 cellsA low CD4 count is not diagnostic of HIV as can also be seen in PID, viral and bacterial infections, lupus and steroid therapy. |
B cell monitoring post rituximab | T, B, NK cells |
HLA DR | Useful marker of activation andMHC Class II deficiency (usually low CD4) |
Naïve T cells | Naïve CD4, Naïve CD8 and Effector CD8 cells |
T cell receptor | Gamma/delta T cells can be increased in infection, autoimmunity, PID and lymphoma |
Regulatory T cells (Tregs) | Detects cells that are CD4+CD25+CD127low |
Double negative T cells | CD3+CD4-CD8-αβ+ T cells seen in ALPS but also other inflammatory and immune dysregulation problems. |
CD11a panel | CD18, CD11a, CD11b, CD11c for LAD-1and CD15 for LAD-2.Suspected leucocyte adhesion molecule deficiency. |
B cell phenotype | Naïve, memory and class-switched memory B cells. |
Dendritic cell screen | Absence of DC and monocytes with B and NK cell deficiency caused by GATA-2 mutations. |
MHC Class I | Bare lymphocyte syndrome |