Table 2.

Clinical range of T cell lymphopenias among 22q11.2DS patients

Thymic hypoplasia (60–70%)More severe thymic hypoplasiaCongenital athymia (<1%)Normal thymus (30–35%)
Reduced CD3+ T cells (<1,500 cells/µl) Low CD3+ T cells (>50 and <400 cells/µl) Very low CD3+ T cells (<50 cells/µl) CD3+ T cells >1,500 cells/µl 
Reduced numbers of naïve T cells and expanded memory T cells Low naïve T cells (>50 cells/µl; >5% and <50% total T cells) Low naïve T cells (<50 cells/µl; <5% total T cells) Higer naïve to memory T cell ratios (infants) 
TREC levels are not flagged as abnormal Undetectable or very low TRECsa Undetectable or very low TRECsa Normal TRECs 
Elevated T follicular helper cells ​ Possible maternal engraftment ​ 
Treatment strategies 
Monitor and possible prophylactics Monitor and possible prophylactics Thymic implant (transplant) Not applicable 
Thymic hypoplasia (60–70%)More severe thymic hypoplasiaCongenital athymia (<1%)Normal thymus (30–35%)
Reduced CD3+ T cells (<1,500 cells/µl) Low CD3+ T cells (>50 and <400 cells/µl) Very low CD3+ T cells (<50 cells/µl) CD3+ T cells >1,500 cells/µl 
Reduced numbers of naïve T cells and expanded memory T cells Low naïve T cells (>50 cells/µl; >5% and <50% total T cells) Low naïve T cells (<50 cells/µl; <5% total T cells) Higer naïve to memory T cell ratios (infants) 
TREC levels are not flagged as abnormal Undetectable or very low TRECsa Undetectable or very low TRECsa Normal TRECs 
Elevated T follicular helper cells ​ Possible maternal engraftment ​ 
Treatment strategies 
Monitor and possible prophylactics Monitor and possible prophylactics Thymic implant (transplant) Not applicable 
a

Flagged by newborn screening and may vary between testing centers.

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