Doctors monitor lymphocyte and other blood cell levels to predict how your lymphoma will progress. Low lymphocyte counts may suggest that cancer has spread to your bone marrow, or it can be a side effect of treatments.
Lymphoma is a group of cancers that develop in your lymphocytes. These white blood cells are found inside your lymph nodes and other parts of your lymph system. Cancerous lymphocytes replicate uncontrollably and can crowd out healthy blood cells.
Doctors don’t use the results of blood tests to diagnose lymphoma, but they can use them to:
- monitor your progression
- monitor how advanced your disease is
- estimate your outlook
Read on to learn more about the role that lymphocyte monitoring plays in diagnosing and treating lymphoma.
What is a lymphocyte?
A lymphocyte is a group of white blood cells. Your white blood cells play an important role in identifying and attacking foreign invaders and cancer cells. Each white blood cell has a specific function depending on its type.
The main types of lymphocytes are:
- B cells: B cells produce molecules called antibodies that tag foreign cells and alert other immune cells that they need to be destroyed.
- T cells: T cells play an important role in your adaptive immunity. Their functions include killing foreign cells, releasing molecules needed to produce inflammation, and helping end your immune response.
- Natural killer cells: Natural killer cells destroy infected cells or cancer cells.
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Blood tests
- blood cells count
- overall health
- organ function
People with lymphoma have high levels of abnormal lymphocytes that replicate quickly. These abnormal cells don’t function properly and can crowd out healthy lymphocytes and other blood cells.
Lower blood cell counts are responsible for many of the characteristic symptoms of lymphoma such as easy bruising and fatigue.
A higher-than-normal level of lymphocytes in your blood suggests you may have blood cancer, but it can also be a sign of some other conditions such as an active infection.
The normal range of lymphocytes can vary between laboratories since laboratories may have different ways to measure your sample. Here’s a general idea of what’s considered a higher or lower
| Range | Name | Value |
|---|---|---|
| Low lymphocyte count | Lymphopenia | 1,000/microliter (μL) |
| Normal lymphocyte count | — | 1,000–4,800/μL |
| High lymphocyte count | Lymphocytosis | 4,800/μL |
Young children typically have higher lymphocyte counts than adults. A doctor may consider your child’s lymphocyte count low if it’s fewer than 2,000/μL.
When examining your blood cell counts, doctors also often look at the breakdown of your total white blood cell count. This test is called a white cell differential test, and it’s often ordered as part of a complete blood count.
The typical percentages in a normal blood sample are:
| White blood cell | Percentage |
|---|---|
| Neutrophils | 55–70% |
| Band neutrophils | 0–3% |
| Lymphocytes | 20–40% |
| Monocytes | 2–8% |
| Eosinophils | 1–4% |
| Basophils | 0.5–1% |
Lymphocytes and other blood cells are produced in stem cells in your bone marrow. A low lymphocyte count is generally associated with a less favorable outlook since lymphocytes help your body monitor and destroy cancer cells.
In a 2019 study, low lymphocyte count trended toward worse survival in people with aggressive non-Hodgkin’s lymphoma but didn’t reach
Researchers in this study reported the following survival rates:
| Lymphocyte count at diagnosis | Median overall survival (years) |
|---|---|
| Fewer than 500/μL | 1.5 |
| 501–1,000/μL | 2.3 |
| 1,001–1,500/μL | 4.25 |
| More than 1,500/μL | 5.2 |
Low blood cell counts can suggest that the cancer has spread to your bone marrow. Special stem cells in your bone marrow produce new blood cells.
Low blood cell counts can also be a side effect of some lymphoma treatments such as chemotherapy. Usually, your blood cell levels return to normal once treatment is finished.
If your cancer treatment is causing your low blood cell count, a doctor may adjust your dose. Blood transfusions are used to help increase your blood cell counts. Immunoglobulin replacement therapy administered through an intravenous (IV) line or injections may help support your immune system.
What other conditions might cause low lymphocyte levels?
Many conditions other than lymphoma can lead to low lymphocyte levels. Some of these conditions include:
- infections
- chemotherapy
- malaria
- high alcohol consumption
- AIDS
- lupus
- enlarged spleen
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A high lymphocyte count can be a sign that you have lymphoma, but it can also be a sign of other conditions such as an active infection.
Factors other than lymphoma that can increase your white blood cell count include:
- infections
- inflammation
- medication side effects
- malnutrition
- thyroid problems
- rheumatoid arthritis
- lupus
- kidney failure
- burns
- severe physical or emotional stress
How is a high lymphocyte count treated?
Your lymphocyte count may return to normal if your cancer treatment is effective. Some of the most common treatments for lymphoma include:
- chemotherapy
- bone marrow transplant
- radiation therapy
- steroid medications
- immunotherapy
- targeted therapies
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Lymphoma starts in a type of white blood cell called lymphocytes. Doctors often monitor lymphocyte and other blood cell counts during the diagnosis and treatment of lymphoma.
Knowing your lymphocyte count isn’t enough to diagnose lymphoma, but it can help doctors predict how your cancer may progress and help determine your best treatment options.
Having a lower-than-normal lymphocyte count is generally associated with a less favorable outlook.
