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HelpTest Code TCRB T-Cell Receptor V-Beta Repertoire Analysis, Spectratyping, Blood
Ordering Guidance
Mayo Clinic Laboratory Director/Consultant approval is required prior to ordering this test in patients greater than 40 years of age.
Additional Testing Requirements
Additional tests that could be ordered in conjunction with this test include:
-TRECS / T-Cell Receptor Excision Circles (TREC) Analysis, Blood
-CD4RT / CD4 T-Cell Recent Thymic Emigrants, Blood
-TCP / T-Cell Subsets, Naive, Memory, and Activated, Blood
Shipping Instructions
Specimens must be received in the laboratory on weekdays and by 4 p.m. on Friday. Collect and package specimen as close to shipping time as possible.
It is recommended that specimens arrive within 24 hours of collection.
Samples arriving over the weekend and/or on observed holidays may be canceled.
Necessary Information
Ordering physician's name and phone number are required.
TCR V beta Spectratyping Assay Patient Information (T719) is required. Testing will proceed without the form; however, results will be held under the information is received.
Specimen Required
For serial monitoring, it is recommended to perform specimen collection at the same time of day, if possible.
Supplies: Ambient Shipping Box-Critical Specimens Only (T668)
Specimen Type: Blood
Container/Tube: Lavender top (EDTA)
Specimen Volume:
Adults: 10 mL
Pediatrics:
-Preferred volume for >1 year: 3 mL
-Preferred volume for ≤1 year: 1 mL
Collection Instructions: Send whole blood specimen in original tube. Do not aliquot.
Forms
TCR V beta Spectratyping Assay Patient Information (T719) is required.
Useful For
Assessment of T-cell receptor diversity in various clinical contexts including inborn errors of immunity (formerly primary immunodeficiencies), monitoring immune reconstitution post-hematopoietic stem cell transplantation, and temporal assessment of repertoire changes in autoimmune diseases and viral infections
Special Instructions
Method Name
Molecular TCR Vb-CDR3 Fragment Length Analysis
Reporting Name
TCRVB Spectratyping, BSpecimen Type
Whole Blood EDTASpecimen Minimum Volume
Adults: 5 mL
Pediatrics: 1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Whole Blood EDTA | Ambient | 48 hours | PURPLE OR PINK TOP/EDTA |
Reference Values
References values will be provided in the patient report.
Interpretation
An interpretive report will be provided with adult and pediatric reference values for the relative contribution of each family to the total repertoire (% diversity ratio). The interpretation will be based on visual analysis of the spectratype (polyclonal, oligoclonal, or monoclonal) for each family as well as assessment of the number of peaks (numerical value not reported), and diversity ratio (DR) (reported value). Information on the distribution of peaks, eg, Gaussian vs non-Gaussian, will also be included in the report, where appropriate. Internal analytical and quality controls will be assessed to determine the suitability of reporting a patient result. Correlation with the clinical context will be made when possible, based on clinical history provided in the patient information sheet, which should be provided with the patient sample.
Clinical Reference
1. Robins HS, Campregher PV, Srivastava SK, et al: Comprehensive assessment of T-cell receptor beta-chain diversity in alphabeta T cells. Blood. 2009;114:4099-4107
2. Arstila TP, Casrouge A, Baron V, et al: A direct estimate of the human alpha-beta T cell receptor diversity. Science. 1999;958-961
3. Brennan RM, Petersen J, Neller MA: The impact of a large and frequent deletion in the human TCR beta locus on antiviral immunity. J Immunol. 2012;188:2742-2748
4. Mackelprang R, Carlson CS, Subrahmanyan L, et al: Sequence variation in the human T-cell receptor loci. Immunol Rev. 2002;190:26-39
5. Warren EH, Matsen IV FA, Chou J: High-throughput sequencing of B- and T-lymphocyte antigen receptors in hematology. Blood. 2013;122:19-22
6. Robins H: Immunosequencing: applications of immune repertoire deep sequencing. Curr Opin Immunol. 2013;25:646-652
7. Gorski J, Yassai M, Zhu X, et al: Circulating T cell repertoire complexity in normal individuals and bone marrow recipients analyzed by CDR3 spectratyping. J Immunol. 1994;152:5109-5119
8. Memon SA, Sportes C, Flomerfelt FA, et al: Quantitative analysis of T cell receptor diversity in clinical samples of human peripheral blood. J Immunol Methods. 2012;375:84-92
9. van Heijst JMJ, Ceberio I, Lipuma LB, et al: Quantitative assessment of T cell repertoire recovery after hematopoietic stem cell transplantation. Nature Medicine. 2013;19:372-378
10. Wada T, Schurman SH, Garabedian EK, et al: Analysis of T-cell repertoire diversity in Wiskott-Aldrich syndrome. Blood. 2005;106:3895-3897
11. Pirovano S, Mazzolari E, Pasic S, et al: Impaired thymic output and restricted T-cell repertoire in two infants with immunodeficiency and early-onset generalized dermatitis. Immunol Letters. 2003;86:93-97
12. Villa A, Notarangelo LD, Roifman CM: Omenn syndrome: inflammation in leaky severe combined immunodeficiency. J Allergy Clin Immunol. 2008;122:1082-1086
13. Sullivan KE: The clinical, immunological and molecular spectrum of chromosome 22q11.2 deletion syndrome and DiGeorge syndrome. Curr Opin Allergy Clin Immunol. 2004;4:505-512
14. Markert ML, Devlin BH, McCarthy EA: Thymus transplantation. Clin Immunol. 2010;135:236-246
Day(s) Performed
Varies
Report Available
20 to 24 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
81340-TRG (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| TCRB | TCRVB Spectratyping, B | 21751-3 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 616418 | CD3 T Cells | 8122-4 |
| 616419 | CD4 T Cells | 24467-3 |
| 616420 | CD8 T Cells | 14135-8 |
| 615831 | Family 2 Diversity Ratio | 82501-8 |
| 615832 | Family 3-1 Diversity Ratio | 82500-0 |
| 615833 | Family 4 Diversity Ratio | 82499-5 |
| 615834 | Family 5 Diversity Ratio | 82498-7 |
| 615835 | Family 6 Diversity Ratio | 82497-9 |
| 615836 | Family 7 Diversity Ratio | 82496-1 |
| 615837 | Family 9 Diversity Ratio | 82495-3 |
| 615838 | Family 10 Diversity Ratio | 82494-6 |
| 615839 | Family 11 Diversity Ratio | 82493-8 |
| 615840 | Family 12 Diversity Ratio | 82492-0 |
| 615841 | Family 13 Diversity Ratio | 82491-2 |
| 615842 | Family 14 Diversity Ratio | 82490-4 |
| 615843 | Family 15 Diversity Ratio | 82489-6 |
| 615844 | Family 16 Diversity Ratio | 82488-8 |
| 615845 | Family 18 Diversity Ratio | 82487-0 |
| 615846 | Family 19 Diversity Ratio | 82486-2 |
| 615847 | Family 20-1 Diversity Ratio | 82485-4 |
| 615848 | Family 24-1 Diversity Ratio | 82484-7 |
| 615849 | Family 25 Diversity Ratio | 82483-9 |
| 615850 | Family 27 Diversity Ratio | 82482-1 |
| 615851 | Family 28 Diversity Ratio | 82481-3 |
| 615852 | Family 29 Diversity Ratio | 82480-5 |
| 615853 | Family 30 Diversity Ratio | 82479-7 |
| 615854 | Interpretation | 69047-9 |
| 615855 | Additional Information | 48767-8 |
| 615856 | Method | 85069-3 |
| 615857 | Disclaimer | 62364-5 |
| 615858 | Released By | 18771-6 |