What are the Symptoms of High Lymphocytes
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What Is Lymphocytosis in Chronic Lymphocytic Leukemia (CLL)?
Medically reviewed by Richard Lin, MD, PhD
If you have chronic lymphocytic leukemia (CLL), you may be concerned if your blood test notes a high lymphocyte count or if your oncologist tells you that you have lymphocytosis. Although this isn’t necessarily something that should cause stress, it is a good idea to understand what it means.
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“Lymphocytes are a subcategory of white blood cells,” said Kerry A. Rogers, MD, a hematologist-oncologist with The Ohio State University Comprehensive Cancer Center in Columbus. “Lymphocytosis is the medical term for a high lymphocyte count, so CLL lymphocytosis refers to what happens when you have a high number of lymphocytes because of CLL cells in the blood,” she noted.
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Whether or not you experience symptoms from CLL lymphocytosis will depend on exactly how high the CLL lymphocyte count is, Dr. Rogers said. In many cases, however, people don’t experience symptoms.
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If your CLL lymphocyte range gets up to 600 or higher, you may have symptoms, but in most cases, any symptoms you experience are more likely to come from the CLL itself than the lymphocytosis, Rogers said.
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“The high white count itself doesn’t cause symptoms, but if you have that much CLL, you may experience things like weight loss from having all the CLL cells releasing hormones in the body,” she added. “You may also see lymph nodes enlarge, which can cause symptoms.”
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Symptoms that can come from CLL itself may include:
Fatigue
Fever
Poor appetite
Weight loss
Enlarged lymph nodes
Night sweats
Enlarged spleen
Should You Be Concerned About CLL Lymphocytosis?
If you recently had blood work and the lab report indicates that you have CLL lymphocytosis, you might wonder if it’s a bad sign, but it’s important not to panic.
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“Oncologists use white blood cell counts to track leukemia progress, so you'll see that people will usually have increasing lymphocyte counts over the course of their disease, and that’s expected,” Dr. Rogers said. “The longer you have CLL, the more often the lymphocytes go up.”
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Some people have very slow-moving CLL, and their CLL lymphocyte counts will remain stable for years, she said. But in most people, the CLL lymphocyte count will change over time, and can decrease during treatment and remission.
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“When it comes down to whether you should worry about high lymphocytes, I guess the question is how high, and how quickly did it get there?” Dr. Rogers said. “If it’s barely above normal, that’s expected in someone with CLL.”
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If, however, you see lymphocytes go from, say, 19 to 230 quickly, that’s a significant change, and something you should discuss with your hematologist, Dr. Rogers said. It could just be due to starting a new treatment, but you should initiate the conversation with your oncology team to investigate further.
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“Just having high lymphocytes on its own isn’t particularly problematic in people with CLL,” Dr. Rogers noted. “Normal lymphocyte counts are between four and 10. People with CLL can get up to 300 or 400, and that’s actually OK. But if you go from 20 to 400 overnight, that’s alarming, and probably something that needs to be addressed with a treatment if you can’t identify a cause, such as a recent infection or something similar to that.”
- Torrey Kim
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