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Evaluation of Diagnostic Usefulness of CD200 Expression in B-cell Chronic Lymphoproliferative Disorders
Abhishek Purohit1, Manali Satiza1, Venkatesan Somasundaram2
1Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan India.
Insights
CD200 expression aids in diagnosing mature B-cell neoplasms (MBNs). This flow cytometry marker is positive in most MBNs, except MCL and PLL, improving diagnostic accuracy.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Mature B-cell neoplasms (MBNs) require accurate immunophenotyping for diagnosis.
- Flow cytometry (FCM) is a key diagnostic tool for MBNs.
- CD200 expression's role in differentiating MBN subtypes is under investigation.
Purpose of the Study:
- To evaluate the diagnostic utility of CD200 expression in MBNs.
- To compare CD200 expression across various MBN subtypes.
- To determine if CD200 can aid in differential diagnosis.
Main Methods:
- Prospective study of 130 suspected MBN cases.
- Immunophenotyping using FCM with a 4-6 color antibody panel.
- Analysis included CD45, CD200, and other relevant B-cell markers, plus kappa and lambda light chains.
Main Results:
- CD200 was positive in 90% (118/130) of MBN cases.
- 100% positivity observed in CLL, atypical CLL, HCL, FL, SMZL, LPL, and low-grade NHL.
- Mantle cell lymphoma (MCL) and prolymphocytic leukemia (PLL) were exclusively CD200 negative.
Conclusions:
- CD200 expression is a valuable marker for MBN diagnosis.
- Its inclusion in FCM panels can improve differential diagnosis of MBNs.
- CD200 aids in distinguishing between various mature B-cell neoplasms.
Abstract:
Immunophenotyping by flow cytometry (FCM) is a useful diagnostic tool for the evaluation of mature B-cell neoplasms (MBN). Here, CD200 expression may play a significant role and improve the distinction between various MBNs, but any potential as a prognostic marker is yet to be established. The present prospective study was conducted on all the suspected cases of MBNs. Immunophenotyping was done using a BD FACS Canto FCM using a panel of 4 to 6 color combinations of monoclonal antibodies; CD45, CD34, CD5, CD19, CD20, CD22, CD23, CD79b, FMC7, CD10, CD38, ZAP70, CD200, IgG, IgM, CD25, CD103, CD2, CD3, CD11c as well as κ and λ light chains. CD200 expression was compared in different subgroups. Of the total of 130 cases included in the study, CD200 was positive in 118 cases (90%). CD200 was expressed in 100% of the cases of CLL(86 cases), atypical CLL(06 cases), HCL(14 cases), FL(02 cases), SMZL(04 cases), LPL (01 case), and low-grade NHL (05 cases), with the highest intensity of fluorescence in HCL followed by CLL. All the cases of MCL and PLL were exclusively negative for CD200. In conclusion, the results of the present study support inclusion of this marker in the flow cytometric panels for the differential diagnosis of MBNs.
