CD2 BY FLOW CYTOMETRY BLOOD

Immunity

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No Fasting Required

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Flow cytometry panel of immune cell surface markers.

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CD2 BY FLOW CYTOMETRY BLOOD

Why is it done?
- CD2 is a glycoprotein surface antigen found on T lymphocytes and natural killer (NK) cells. This test measures the percentage and absolute count of CD2+ cells in peripheral blood using flow cytometry analysis.
- Evaluation of immune function and T-cell abnormalities in patients with suspected lymphoproliferative disorders, immunodeficiencies, or hematologic malignancies.
- Diagnosis and classification of lymphomas, leukemias, and T-cell disorders including T-cell acute lymphoblastic leukemia (T-ALL), T-cell lymphomas, and peripheral T-cell lymphomas.
- Assessment of immunodeficiency states such as DiGeorge syndrome, combined immunodeficiencies, and severe infections where T-cell populations are compromised.
- Monitoring response to immunotherapy, chemotherapy, or bone marrow/stem cell transplantation.
- Investigation of abnormal lymphocyte counts in complete blood count (CBC) results.
Normal Range
- CD2+ Cell Percentage: 50-84% of lymphocytes (typical reference range varies by laboratory and age group)
- CD2+ Absolute Count: 1,000-4,800 cells/μL or 1.0-4.8 × 10³/μL (reference ranges vary by laboratory and patient age)
- Unit of Measurement: Percentage (%) and absolute count (cells/μL or 10³/μL)
- Normal Result: CD2+ cells represent the majority of T lymphocytes, indicating appropriate T-cell development and immune competence. Values within the reference range suggest normal T-cell populations.
- Abnormal Result: Decreased CD2+ percentage or absolute count may indicate T-cell immunodeficiency, lymphoma, leukemia, or acquired immune disorders. Increased counts may suggest reactive lymphocytosis, certain infections, or T-cell proliferative disorders.
- Note: Individual laboratory reference ranges should be consulted as they may differ based on methodology, instrument calibration, and patient demographics.
Interpretation
- Decreased CD2+ Count (Below Reference Range):
  - Suggests T-cell lymphopenia or immunodeficiency states such as HIV infection, DiGeorge syndrome, or severe combined immunodeficiency (SCID)
  - May indicate T-cell leukemia where abnormal CD2-negative blast cells predominate
  - Can be seen in certain lymphomas or T-cell disorders with antigen loss
  - May result from bone marrow transplantation complications or post-immunosuppressive therapy
- Increased CD2+ Count (Above Reference Range):
  - Indicates reactive lymphocytosis associated with infections (viral, bacterial, or parasitic)
  - May suggest T-cell lymphoproliferative disorders or certain T-cell lymphomas with expanded CD2+ populations
  - Can occur in autoimmune conditions with T-cell activation such as systemic lupus erythematosus (SLE) or rheumatoid arthritis
  - May reflect immune reconstitution after chemotherapy or bone marrow transplantation
- Factors Affecting Results:
  - Patient age - reference ranges differ between children and adults
  - Active infection or immunosuppression status
  - Recent vaccination or immunizations
  - Medications including corticosteroids or immunosuppressive drugs
  - Circadian rhythm and time of blood draw
  - Specimen handling and transportation time
  - Flow cytometry instrument calibration and methodology used
- Clinical Significance:
  - CD2 serves as a pan-T-cell marker; its expression helps identify and quantify T-lymphocyte populations in the blood
  - Most T-ALL cases are CD2-positive; loss of CD2 expression may indicate antigen abnormalities or specific lymphoma subtypes
  - Used in combination with other CD markers (CD3, CD4, CD8, CD5) for comprehensive immune phenotyping
  - Important for diagnosing T-cell immunodeficiency syndromes and monitoring immune recovery
Associated Organs
- Primary Organ System:
  - Immune/Lymphatic System - T lymphocytes originate in bone marrow and mature in the thymus
  - Hematologic System - blood production and circulation in peripheral blood
- Medical Conditions Associated with Abnormal CD2 Results:
  - T-cell Acute Lymphoblastic Leukemia (T-ALL) - typically CD2-positive with elevated immature T-cells
  - Peripheral T-cell Lymphoma (PTCL) - may show abnormal CD2 expression patterns with clonal populations
  - T-cell Prolymphocytic Leukemia (T-PLL) - abnormal CD2+ prolymphocyte accumulation in blood
  - HIV/AIDS - reduced CD2+ T-cell counts indicating immunosuppression and disease progression
  - DiGeorge Syndrome (22q11 deletion) - severely decreased CD2+ T-cell counts due to thymic hypoplasia
  - Severe Combined Immunodeficiency (SCID) - profoundly decreased T-lymphocytes including CD2+ cells
  - Autoimmune disorders - elevated CD2+ counts with T-cell activation (SLE, rheumatoid arthritis)
  - Mycosis Fungoides/Cutaneous T-cell Lymphoma (CTCL) - may show abnormal CD2 expression on malignant T-cells
  - Post-transplant lymphoproliferative disorder (PTLD) - T-cell proliferation following bone marrow or solid organ transplantation
  - Ataxia-Telangiectasia - variable T-cell abnormalities with CD2+ deficiency
  - Chronic infections (viral, bacterial, fungal, parasitic) - reactive T-cell lymphocytosis with elevated CD2+
- Potential Complications/Risks from Abnormal Results:
  - Severe immunosuppression leading to life-threatening opportunistic infections
  - Cancer development or progression in T-cell malignancies if not treated appropriately
  - Delayed diagnosis leading to advanced stage at presentation in lymphomas and leukemias
  - Graft rejection or graft-versus-host disease (GVHD) following stem cell transplantation
  - Severe autoimmune manifestations if T-cell activation is markedly elevated
  - Increased susceptibility to unusual infections in immunodeficient patients
Follow-up Tests
- Comprehensive Lymphocyte Phenotyping:
  - CD3, CD4, CD8, CD5, CD7, CD20 to characterize T-cell subsets and B-cells
  - CD19 for B-lymphocyte quantification
  - CD56, CD16 for natural killer cell identification
- Additional Immunologic Testing:
  - T-cell receptor (TCR) gene clonality studies - to detect clonal T-cell populations suggesting lymphoma or leukemia
  - Immunoglobulin gene clonality - for B-cell lineage assessment
  - Cytochemical stains and morphologic review of blood smear
  - Immunofixation electrophoresis (IFE) or serum protein electrophoresis if monoclonal protein suspected
- Cytogenetic and Molecular Studies:
  - Chromosome analysis (karyotyping) for chromosomal abnormalities
  - Fluorescence in situ hybridization (FISH) for specific leukemia/lymphoma translocations
  - Next-generation sequencing (NGS) for gene mutations in myeloid and lymphoid disorders
- Specific Clinical Scenarios:
  - If CD2 count is abnormally low: HIV serology and viral load testing, thymus imaging if DiGeorge syndrome suspected
  - If T-cell lymphoma suspected: Bone marrow biopsy with flow cytometry, tissue biopsy for lymph node or skin involvement
  - If T-ALL suspected: Complete blood count (CBC), chemistry panel, lactate dehydrogenase (LDH), uric acid
  - Post-transplant monitoring: Serial CD2 counts to assess immune reconstitution every 1-3 months
- Imaging and Other Diagnostic Studies:
  - Chest X-ray or CT scan if lymphoma or leukemia with mediastinal involvement suspected
  - Positron emission tomography (PET) scan for lymphoma staging and monitoring
  - Abdominal ultrasound or CT for hepatosplenomegaly assessment in lymphoid malignancies
- Monitoring Frequency:
  - During chemotherapy: Monthly or as clinically indicated
  - Post-transplant: Every 1-3 months during first year, then every 3-6 months
  - HIV-positive patients: Every 3-6 months during treatment or when CD2 count changes clinically
  - In remission from malignancy: Every 3-6 months for surveillance depending on treatment protocol
Fasting Required?
- No fasting is required - CD2 flow cytometry blood test can be performed at any time without dietary restrictions.
- Patient Preparation:
  - No special fasting requirements; patient may eat and drink normally before the test
  - Arrive well-hydrated to facilitate blood draw
  - Inform the phlebotomist of any active medications being taken
  - Avoid strenuous exercise immediately before testing as it may affect lymphocyte counts
- Medications:
  - No medications need to be stopped; continue taking regular medications as prescribed
  - Notify healthcare provider of immunosuppressive drugs, corticosteroids, chemotherapy agents, or biologics that may affect results
  - Recent vaccinations should be noted as they may transiently elevate CD2+ counts
- Specimen Collection:
  - Blood sample collected via venipuncture into an EDTA (ethylenediaminetetraacetic acid) tube (lavender top)
  - Specimen should be gently mixed by inversion 8-10 times to ensure adequate anticoagulation
  - Sample must be transported to laboratory within 24-48 hours at room temperature; refrigeration not recommended for flow cytometry specimens
  - Delays in processing may result in cell death and inaccurate results
- General Instructions:
  - Wear comfortable, loose-fitting clothing with short or rolled-up sleeves for easy blood draw access
  - Avoid physical or emotional stress immediately before testing
  - Best collected during morning hours (8-10 AM) for consistency with circadian lymphocyte variations
  - Inform provider of recent infections or illnesses as they may affect CD2 results
  - No special post-collection care needed; patient may resume normal activities immediately

How our test process works!