Dear Editor
We read Purohit ‘s paper [1] with great interest who used the flow cytometry to evaluate the dignostic role of CD200 in the differential diagnosis of different mature B-cell neoplasms. They found that the CD200 was expressed in 100% of the cases of chronic lymphocytic leukemia (CLL), atypical CLL, hairy cell leukemia (HCL), Follicular lymphoma (FL), splenic marginal zone lymphoma (SMZL), lymphoplasmacytic lymphoma (LPL), and low-grade non-Hodkin’s lymphoma, with the highest intensity of fluorescence in HCL followed by CLL, and all cases of mantle cell lymphoma (MCL) and prolymphocytic leukemia (PLL) were exclusively negative for CD200. In conclusion, they highlighted the critical role of CD200 in the differential diagnosis of different mature B-cell neoplasms.
CD200, a transmembrane type Ia glycoprotein belonging to the immunoglobulin protein superfamily, is broadly expressed on a wide variety of cell types. Overexpression of CD200 has been reported in CLL and HCL but not in MCL, thus helping to better discriminate between these different B cell malignancies with different prognosis [2, 3]. Mature B-cell neoplasms are challenging to diagnose due to their heterogeneity and overlapping clinical and biological features [3]. Therefore, the positivity percentage (calculated on total lymphocytes) and median fluorescent intensity (MFI, measured on clonal B cells) are utilized for the evaluation for the differetial diagnosis of these mature B cell neoplasm [3]. However, the data about the positivity percentage of CD200 was not well documented, althought the CD200 expression levels intensity on neoplastic B-lymphocytes was well displayed in various mature B neoplasms in figure 1 of Purohit ‘s paper [1]. But in our daily practice on the diagnosis of these mature B-cell neoplasms, we usually define the negative (< 20% gating on CD19+ neoplastic cells), weak postive (20-80% gating on CD19+ neoplastic cells) and positive (> 80% gating on CD19+ neoplastic cells) for the surface marker, including this CD200 transmembrane type Ia glycoprotein. Thus, clearly showed the data of the positivity percentage of CD200 will definitely add a critical role on the differential diagnosis of these mature B-cell neoplasms in Purohit ‘s paper [1].
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Author contribution
CY, WD and WP participate in the data analysis and discussion and wrote the manuscript.
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We declare no competing interests.
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Can Yan, Weichu Dai, and Na Shi have equally contributed to this work.
References
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