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HelpTest Code LPAGF Lymphocyte Proliferation to Antigens, Blood
Reporting Name
Lymphocyte Proliferation, AntigensUseful 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.
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
WB Sodium HeparinOrdering 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 |
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 |
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
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 |
Report Available
11 to 14 daysReject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
Method Name
Flow Cytometry
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.