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HelpTest Code LAB1268 B-Cell Phenotyping Profile for Immunodeficiency and Immune Competence Assessment, Blood
Additional Codes
| Mayo Test ID |
| IABCS |
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Screening for common variable immunodeficiency and hyper-IgM syndromes
Assessing B-cell subset reconstitution after stem cell or bone marrow transplant
Assessing response to B-cell-depleting immunotherapy
This test is not indicated for the evaluation of lymphoproliferative disorders (eg, leukemia, lymphoma, multiple myeloma).
Testing Algorithm
When multiple specimen types are required to perform a panel of tests, the laboratory will perform the tests for which the appropriate specimen type was received. The laboratory will cancel those for which the appropriate specimen was not received. Be advised that this may change the degree of interpretation received with the report.
Method Name
Flow Cytometry
Reporting Name
Immune Assessment B Cell Subsets, BSpecimen Type
Whole Blood EDTAOrdering Guidance
The IABCS is a panel test. This test requires two separate whole blood EDTA specimens at two different transport temperatures: one ambient and one refrigerate.
The TBBS / Quantitative Lymphocyte Subsets: T, B, and Natural Killer (NK) Cells, Blood is automatically performed, a separate order is not required.
If only an ambient EDTA specimen is received, only the TBBS / Quantitative Lymphocyte Subsets: T, B, and Natural Killer (NK) Cells, Blood will be performed. If only a refrigerate EDTA sample is received, this test will be canceled and converted to RBCS / Relative B-Cell Subset Analysis Percentage, Blood, which provides the relative B-cell subset values without quantitation.
This test is a screening test and further analyses will be required to complete a diagnostic workup for hyper-IgM (XHIM / X-Linked Hyper IgM Syndrome, Blood and CD40 / B-Cell CD40 Expression by Flow Cytometry, Blood).
Shipping Instructions
Testing is performed Monday through Friday. The test may be canceled if specimens are not received in the laboratory by Friday at 8 p.m. Central time.
Samples arriving on weekends and observed holidays may be canceled.
Collect and package specimens as close to shipping time as possible.
It is recommended that specimens arrive within 24 hours of collection.
Necessary Information
1. Date of collection is required.
2. Ordering healthcare professional name and phone number are required.
Specimen Required
Two separate EDTA whole blood specimens are required: 1 refrigerate and 1 ambient transport temperature.
For serial monitoring, it is recommended that specimens are collected at the same time of day.
Specimen Type: Whole blood for TBBS / Quantitative Lymphocyte Subsets: T, B, and Natural Killer (NK) Cells, Blood
Container/Tube: 4 mL Lavender top (EDTA)
Specimen Volume: 3 mL
Collection Instructions:
1. Send whole blood specimen in original tube. Do not aliquot.
2. Label specimen as TBBS.
3. Ship ambient.
Specimen Stability Information: Ambient <52 hours
Specimen Type: Whole blood for IABC / B-Cell Phenotyping Screen for Immunodeficiency and Immune Competence Assessment, Blood
Container/Tube: Lavender top (EDTA)
Specimen Volume:
≤14 years: 4 mL
>14 years: 10 mL
Collection Instructions:
1. Send whole blood specimen in original tube. Do not aliquot.
2. Label specimen IABC.
3. Ship refrigerate.
Specimen Stability Information: Refrigerated <48 hours
Specimen Minimum Volume
TBBS: 1 mL; IABC: > 14 years: 5 mL; ≤ 14 years: 3 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Whole Blood EDTA | Varies | 48 hours | PURPLE OR PINK TOP/EDTA |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
Reference Values
The appropriate age-related reference values will be provided on the report.
Interpretation
Quantitative Lymphocyte Subsets: T, B, and natural killer:
When the CD4 count falls below 500 cells/mcL, patients who are HIV-positive can be diagnosed with AIDS and can receive antiretroviral therapy.
When the CD4 count falls below 200 cells/mcL, prophylaxis against Pneumocystis jiroveci pneumonia is recommended.
Immune Assessment B Cell Subsets:
The assay provides quantitative information on the various B-cell subsets (percentage and absolute counts in cells/microliter). Each specimen is evaluated for B-cell subsets with respect to the total number of CD19+ B cells present in the peripheral blood mononuclear cell population, compared to the reference range. In order to verify that there are no CD19-related defects, CD20 is used as an additional pan-B-cell marker (expressed as percentage of CD45+ lymphocytes).
The B-cell panel assesses the following B-cell subsets:
CD19+=B cells expressing CD19 as a percent of total lymphocytes
CD19+ CD27+=total memory B cells
CD19+ CD27+ IgD+ IgM+=marginal zone or non-switched memory B cells
CD19+ CD27+ IgD- IgM+=IgM-only memory B cells
CD19+ CD27+ IgD- IgM-=class-switched memory B cells
CD19+ IgM+=IgM B cells
CD19+ CD38+ IgM+=transitional B cells
CD19+ CD38+ IgM-=plasmablasts
CD19+ CD21-=CD21 low ("immature") B cells
CD19+ CD21+=mature B cells
CD19+ CD20+=B cells coexpressing both CD19 and CD20 as a percent of total lymphocytes
Day(s) Performed
Monday through Friday
Report Available
3 to 4 daysSpecimen Retention Time
PBMC:7 daysTest Classification
This test was developed using an analyte specific reagent. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
86355-B cells, total count
86357-Natural killer (NK) cells, total count
86359-T cells, total count
86360-Absolute CD4/CD8 count with ratio
86356 x7 - Mononuclear cell antigen, quantitative
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| IABCS | Immune Assessment B Cell Subsets, B | 90416-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 30296 | CD19+ % of total Lymphocytes | 8117-4 |
| 3321 | CD45 Total Lymph Count | 27071-0 |
| 3316 | % CD3 (T Cells) | 8124-0 |
| 29094 | CD20+ % of total Lymphocytes | 8119-0 |
| 3322 | CD3 (T Cells) | 8122-4 |
| 30298 | CD27+ % of CD19+ B cells | 89358-6 |
| 3319 | % CD4 (T Cells) | 8123-2 |
| 30300 | CD27+ IgM+ IgD+ % of CD19+ B cells | 89352-9 |
| 3325 | CD4 (T Cells) | 24467-3 |
| 30302 | CD27+ IgM- IgD- % of CD19+ B cells | 89350-3 |
| 3320 | % CD8 (T Cells) | 8101-8 |
| 30304 | CD27+ IgM+ IgD- % of CD19+ B cells | 89348-7 |
| 3326 | CD8 (T Cells) | 14135-8 |
| 30306 | IgM+ % of CD19+ B cells | 89346-1 |
| 3318 | % CD19 (B Cells) | 8117-4 |
| 30308 | CD38+ IgM- % of CD19+ B cells | 89344-6 |
| 30310 | CD38+ IgM+ % of CD19+ B cells | 89341-2 |
| 3324 | CD19 (B Cells) | 8116-6 |
| 4054 | % CD16+CD56 (NK cells) | 8112-5 |
| 30312 | CD21+ % of CD19+ B cells | 89356-0 |
| 30314 | CD21- % of CD19+ B cells | 89355-2 |
| 4055 | CD16+CD56 (NK cells) | 20402-4 |
| 3327 | 4/8 Ratio | 54218-3 |
| 30297 | CD19+ | 8116-6 |
| 29095 | CD20+ | 9558-8 |
| 6657 | Comment | 80722-2 |
| 30299 | CD27+ | 89353-7 |
| 30301 | CD27+ IgM+ IgD+ | 89351-1 |
| 30303 | CD27+ IgM- IgD- | 89349-5 |
| 30305 | CD27+ IgM+ IgD- | 89347-9 |
| 30307 | IgM+ | 89345-3 |
| 30309 | CD38+ IgM- | 89343-8 |
| 30311 | CD38+ IgM+ | 89357-8 |
| 30313 | CD21+ | 25164-5 |
| 30315 | CD21- | 89354-5 |
| 30316 | Interpretation | 80722-2 |
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| TBBS | QN Lymphocyte Subsets: T, B, and NK | Yes | Yes |
| IABC | Immune Assessment B Cell Subsets, B | No | Yes |