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Published on: January 7, 2019
CD200 expression in B-cell chronic lymphoproliferative disorders
Nermeen Ahmed El Desoukey1, Reham Abd Aleem Afify, Dalia Gamil Amin
1Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Insights
CD200 expression aids in diagnosing B-cell chronic lymphoproliferative disorders (BCLPDs). High CD200 levels distinguish B-cell chronic lymphocytic leukemia (CLL) and hairy cell leukemia, suggesting potential targeted therapies.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Flow cytometry immunophenotyping (FCIP) is crucial for diagnosing B-cell chronic lymphoproliferative disorders (BCLPDs).
- Typical FCIP panels may require additional markers for accurate differential diagnosis due to immunophenotypic variations.
- Emerging research suggests CD200 expression may be a useful marker in certain BCLPDs.
Purpose of the Study:
- To evaluate CD200 expression across various BCLPD subtypes.
- To determine if CD200 can enhance the differential diagnosis capabilities of routine FCIP panels for BCLPDs.
Main Methods:
- CD200 expression was assessed using tricolor FCIP in 49 BCLPD patients and 26 controls.
- Standard FCIP markers (CD5, CD19, sIg, CD23, CD22, CD79b, FMC7) were used, with additional markers for specific BCLPDs.
- Expression levels were analyzed for CD200 on CD19/22-positive cells.
Main Results:
- All B-cell chronic lymphocytic leukemia (B-CLL) patients (100%) exhibited high, bright CD200 expression (mean 94%).
- Hairy cell leukemia cases also showed bright CD200 expression (96%, 99%).
- Other BCLPDs, including mantle cell lymphoma, follicular lymphoma, and splenic marginal zone lymphoma, displayed significantly lower, dim CD200 expression (mean 10%).
Conclusions:
- CD200 evaluation significantly improves the accuracy of BCLPD diagnosis and can be incorporated into routine FCIP panels.
- High CD200 expression in B-CLL and hairy cell leukemia suggests potential for targeted anti-CD200 immunotherapy.
Background:
Flow cytometry immunophenotyping (FCIP) is used for rapid, specific diagnosis of B-chronic lymphoproliferative disorders (BCLPDs). However, cases may deviate from the typical immunophenotype; therefore, there is a need for adding new marker(s) for differentiating BCLPDs.Lately, few researches highlighted CD200 expression in some BCLPDs. Our aim was to evaluate CD200 expression in different BCLPDs and whether adding CD200 to BCLPD-FCIP routine panels could improve the ability of their differential diagnosis.
Methods:
We evaluated CD200 expression in 49 BCLPD patients and 26 age- and sex-matched control subjects. Flow cytometry immunophenotyping first panel included CD5, CD19, sIg, CD23, CD22, CD79b, and FMC7; for BCLPDs other than chronic lymphocytic leukemia (CLL) and mantle cell lymphoma, CD11c, CD103, CD25, and CD10 were evaluated.
Results:
Using tricolor FCIP, CD200 showed high bright expression on CD5/19-positive clone in all B-CLL patients (100%), with a mean of 94% (SD, 11%); in the 2 cases of hairy cell leukemia, CD200 was brightly expressed on 96% and 99% of cells. In all other BCLPDs including mantle cell lymphoma, follicular lymphoma and splenic marginal zone lymphoma, CD200 expression (on CD19/22-positive cells) was less than 20% with a mean of 10% (SD, 8%) and a dim pattern. CD200 expression was significantly higher in CLL compared with non-Hodgkin lymphoma groups (P < 0.001).
Conclusions:
Evaluating CD200 expression has a great impact on accurate BCLPDs diagnosis and could be added to the BCLPD routine panels. The high expression of CD200 in B-cell CLL and hairy cell leukemia could open the option for targeted immune (anti-CD200) therapy.
