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Test ID LPAGF Lymphocyte Proliferation to Antigens, Blood

Important Note

Specimen to be collected Monday-Thursday. Deliver directly to Mayo processor. Ship to Mayo on the same day of collection.

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.

Method Name

Flow Cytometry

Reporting Name

Lymphocyte Proliferation, Antigens

Specimen Type

WB Sodium Heparin

Ordering Guidance

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

Shipping Instructions

Specimens must be received in the laboratory weekdays and by 4 p.m. on Friday. 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.


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

Necessary Information

1. Date and time of collection

2. Ordering physician 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


>18.5 mL

>40 mL


18.5 mL

40 mL


8.5 mL

20 mL


6.0 mL

12 mL


4.5 mL

10 mL


3.0 mL

6 mL


2.5 mL

5 mL


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


>28 mL

>60 mL


28 mL

60 mL


12 mL

30 mL


8.5 mL

20 mL


6.5 mL

15 mL


4.5 mL

10 mL


3.5 mL

8 mL


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

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information


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

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.

Report Available

11 to 14 days

NY State Approved


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.