CD20 is a transmembrane protein expressed on nearly all mature B lymphocytes, from the late pre-B stage through memory B cells. It is not present on early transitional B cells or on plasma cells, making CD20 a highly specific marker for assessing the pool of functionally mature B cells capable of responding to antigens.
Because of its restricted expression pattern, CD20 plays an essential role in immune monitoring—especially in patients receiving anti-CD20 therapies such as rituximab, ocrelizumab, or ofatumumab. These treatments deplete CD20-expressing B cells, and tracking CD20+ counts is critical for evaluating therapeutic effectiveness and immune reconstitution.
Elevated CD20+ B-cell counts may indicate increased B-cell production, chronic immune activation, or autoimmune conditions such as systemic lupus erythematosus (SLE) or rheumatoid arthritis. Higher values may also occur with infections or lymphoproliferative disorders.
Low CD20+ B-cell counts typically reflect targeted depletion after anti-CD20 therapy, impaired B-cell development, bone marrow suppression, or primary immunodeficiencies such as CVID. Persistently low levels can contribute to reduced antibody production and increased infection susceptibility.
Clinically, CD20+ B-cell measurement is used to:
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Monitor response to B-cell–depleting therapies
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Track immune reconstitution after immunosuppression
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Assess suspected immunodeficiency
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Help evaluate autoimmune activity or chronic inflammation
What does it mean if your CD20+ result is too high?
High CD20+ B cells may occur with increased B-cell activation or expansion, as seen in autoimmune diseases (SLE, RA), chronic infections, or lymphoproliferative disorders. Elevated values may indicate ongoing inflammation, immune dysregulation, or increased B-cell turnover.
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What does it mean if your CD20+ result is too low?
Low CD20+ B cells may reflect B-cell depletion from anti-CD20 therapies (e.g., rituximab), impaired B-cell maturation, primary immunodeficiency (such as CVID), or bone marrow suppression. Persistently low levels may impair antibody production and weaken overall immune defense.
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