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Test Code LPAGF Lymphocyte Proliferation to Antigens, Blood


Ordering Guidance


This test should not be ordered for patients younger than 3 months unless there is a clinical history of candidiasis. For more information see Cautions.



Shipping Instructions


Testing performed Monday through Friday. Specimens not received by 4 p.m. Central time on Friday may be canceled.

 

Specimens arriving on the weekend and observed holidays may be canceled.

 

Collect and package specimen as close to shipping time as possible. Ship specimen overnight in an Ambient Shipping Box-Critical Specimens Only (T668) following the instructions in the box. It is recommended that specimens arrive within 24 hours of collection.



Necessary Information


1. Date and time of collection

2. The ordering healthcare professional's name and phone number are required.



Specimen Required


Supplies: Ambient Shipping Box-Critical Specimens Only (T668)

Container/Tube: Green top (sodium heparin)

Specimen Volume: 20 mL

See tables for information on recommended volume based on absolute lymphocyte count

Pediatric Volume:

<3 months: 1 mL

3-24 months: 3 mL

25 months-18 years: 5 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.

 

Table. Blood Volume Recommendations Based on Absolute Lymphocyte Count (ALC)

Antigen only

ALC x 10(9)/L

Blood volume for minimum Candida albicans (CA) and tetanus toxoid (TT) Only

Blood volume for full assay

<0.5

>18.5 mL

>40 mL

0.5-1.0

18.5 mL

40 mL

1.1-1.5

8.5 mL

20 mL

1.6-2.0

6.0 mL

12 mL

2.1-3.0

4.5 mL

10 mL

3.1-4.0

3.0 mL

6 mL

4.1-5.0

2.5 mL

5 mL

>5.0

2.0 mL

4 mL

 

Mitogen and antigen

ALC x 10(9)/L

Blood volume for minimum of each assay

Blood volume for full assay

<0.5

>28 mL

>60 mL

0.5-1.0

28 mL

60 mL

1.1-1.5

12 mL

30 mL

1.6-2.0

8.5 mL

20 mL

2.1-3.0

6.5 mL

15 mL

3.1-4.0

4.5 mL

10 mL

4.1-5.0

3.5 mL

8 mL

>5.0

2.5 mL

6 mL


Useful For

Assessing T-cell function in patients on immunosuppressive therapy, including solid-organ transplant patients

 

Evaluating patients suspected of having impairment in cellular immunity

 

Evaluation of T-cell function in patients with primary immunodeficiencies, either cellular (DiGeorge syndrome, T-negative severe combined immunodeficiency [SCID], etc) or combined T- and B-cell immunodeficiencies (T- and B-negative SCID, Wiskott-Aldrich syndrome, ataxia telangiectasia, common variable immunodeficiency, among others) where T-cell function may be impaired

 

Evaluation of T-cell function in patients with secondary immunodeficiency, either disease related or iatrogenic

 

Evaluation of recovery of T-cell function and competence following bone marrow transplantation or hematopoietic stem cell transplantation

 

This test is not intended for assessment of maternal engraftment.

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
AGSTM Additional Flow Stimulant, LPAGF No, (Bill Only) No

Testing Algorithm

To ensure the most reliable results, if insufficient peripheral blood mononuclear cells are isolated from the patient's sample due to low white blood cell counts or specimen volume received, selected dilutions or stimulants may not be tested at the discretion of the laboratory.

 

Testing with one stimulant will always be performed. When adequate specimen is available for both stimulants to be tested, the second stimulant will be evaluated at an additional charge.

Method Name

Flow Cytometry

Reporting Name

Lymphocyte Proliferation, Antigens

Specimen Type

WB Sodium Heparin

Specimen Minimum Volume

<6 years: 1 mL; 6-18 years: 2 mL; >18 years: 6 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
WB Sodium Heparin Ambient 48 hours GREEN TOP/HEP

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject

Reference Values

Viability of lymphocytes at day 0: ≥75.0%

Maximum proliferation of Candida albicans as % CD45: ≥5.7%

Maximum proliferation of Candida albicans as % CD3: ≥3.0%

Maximum proliferation of tetanus toxoid as % CD45: ≥5.2%

Maximum proliferation of tetanus toxoid as % CD3: ≥3.3%

Day(s) Performed

Monday through Friday

Report Available

11 to 14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test 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

86353

86353 (if appropriate)

 

LOINC Code Information

Test ID Test Order Name Order LOINC Value
LPAGF Lymphocyte Proliferation, Antigens 69042-0

 

Result ID Test Result Name Result LOINC Value
32325 Interpretation 69052-9
32326 Viab of Lymphs at Day 0 33193-4
32327 Max Prolif of CA as % CD45 69014-9
32328 Max Prolif of CA as % CD3 69015-6
32329 Max Prolif of TT as % CD45 69016-4
32330 Max Prolif of TT as % CD3 69029-7
32331 Antigen Comment 48767-8