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CD 200 - A useful marker in chronic B lymphoprolipherative disorders
A Iova1, A Vlădăreanu1, H Bumbea1
1Department of Hematology, University Emergency Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest.
Insights
CD200 is a valuable marker for diagnosing B-cell chronic lymphoproliferative disorders, particularly distinguishing chronic lymphocytic leukemia (CLL) from mantle cell lymphoma (MCL). Its high expression in CLL and hairy cell leukemia (HCL) aids diagnosis and may guide targeted therapy.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Diagnosis of chronic lymphoproliferative diseases relies on immunological criteria.
- Flow cytometry immunophenotyping is crucial but requires new markers for atypical cases.
- CD200, a membrane glycoprotein, is overexpressed in malignancies like CLL.
Purpose of the Study:
- To evaluate CD200 expression in various B-cell chronic lymphoproliferative disorders.
- To assess the diagnostic utility of CD200 in differentiating between specific B-cell malignancies.
- To explore the potential of CD200 as a therapeutic target.
Main Methods:
- Analyzed CD200 expression in 122 patients with B-cell chronic lymphoproliferative disorders.
- Included patients with chronic lymphocytic leukemia (CLL), splenic marginal zone lymphoma (SMZL), mantle cell lymphoma (MCL), and hairy cell leukemia (HCL).
- Utilized immunophenotypical analysis via flow cytometry on peripheral blood and bone marrow aspirates.
Main Results:
- CD200 was brightly expressed in 100% of CLL patients and 96-97% of HCL patients.
- CD200 showed dim positivity in 40-60% of SMZL patients and was negative in MCL patients (1-10%).
- Significantly higher CD200 expression was observed in CLL compared to other B-cell disorders; identified 14 cases with CD19+, CD5+, CD23- phenotype and high CD200 expression.
Conclusions:
- CD200 expression significantly aids in diagnosing B-cell chronic lymphoproliferative disorders.
- CD200 is particularly useful for differentiating CLL from MCL, potentially offering higher specificity than CD23.
- High CD200 expression in CLL and HCL suggests potential for novel anti-CD200 targeted therapies.
Abstract:
Background: The diagnosis and management of the patients with chronic lymphoproliferative diseases have become dependent on immunological criteria. Flow cytometry immunophenotyping is used for rapid and specific diagnosis but there are cases when we are not facing a typical immunophenotype, so there is a constant need to find new markers and new combinations of markers that would allow the improvement and the development of our diagnosis. Aim: Our aim was to evaluate CD 200 expression in different B-cell chronic lymphoproliferative disorders. CD200 is a membrane glycoprotein belonging to the immunoglobulin superfamily and the over-expression of CD200 has been reported in a number of malignancies, including CLL, as well as on cancer stem cells. Methods: We analyzed the CD200 expression in 122 patients diagnosed with chronic lymphoproliferative disorders (100 patients with CLL, 10 patients with splenic marginal zone lymphoma (SMZL), 10 patients with MCL and 2 patients with hairy cell leukemia), in the Department of Hematology of the University Emergency Hospital, Bucharest. We performed immunophenotypical analysis of peripheral blood and bone marrow aspiration on BD FACS Calibur flowcytometer. Results: CD200 was brightly expressed in all 100 CLL patients (100%). In SMZL patients, CD200 was dim positive (40%-60%), in patients with HCL. CD200 was also bright positive (96% and 97%) and in patients with MCL CD200 was negative (1-10%); CD 200 was significantly higher in CLL patients compared with other B-cell chronic lymphoproliferative disorders. We found 14 patients with CD19, CD5 positive population and CD23- , but with high expression of CD 200. Cyclin D1 was negative on bone marrow biopsy in 13/14 of these patients. (1/14 patients were without bone marrow involvement); Conclusions: CD200 has a great impact in diagnosing B- chronic lymphoproliferative disorders, especially when we want to determine the origin of a CD19, CD5 positive population and distinguish between CLL and MCL. CD 23 is a reliable marker in those cases, but, as we showed, CD23 might have a lower specificity than CD200 for CLL. We added CD200 in our panels in order to diagnose chronic lymphoproliferative disorders, not to replace CD 23, but to improve and save time in our diagnostic process. The high expression of CD200 in CLL and HCL could open the option for new- targeted therapy (anti-CD200).
