Elevated Lymphocytes: Should You Worry About Leukemia?

Blood disorders

Hello, doctor.
I would like to ask you a few questions.
Two weeks ago, I went to the emergency room at Chang Gung Hospital due to dizziness, general weakness, and nausea.
My blood test results showed low potassium levels, mild jaundice, and elevated lymphocyte counts.
The emergency doctor did not mention the elevated lymphocyte count or its value at that time.
Later, when I went to the gastroenterology department for blood tests, the doctor informed me about the elevated lymphocyte count.
I am unsure if the emergency doctor thought it was not significant, which is why it was not mentioned.
I am very concerned about leukemia, so I asked the emergency doctor if it could be leukemia, and he said it was not.
The next day, the gastroenterologist arranged for an ultrasound, endoscopy, and blood tests.
A week later, when I reviewed the reports, the ultrasound was normal, but there was a gastric ulcer.
At that point, the gastroenterologist mentioned that the lymphocyte count was slightly elevated but said it was not a concern and did not specify the value.
I was still worried and asked if it could be leukemia, to which the doctor casually replied that it was not and did not schedule a follow-up blood test.
He only scheduled a blood test for a month later because he noticed my anxiety.
Could you please explain why my lymphocyte counts have been above normal for two consecutive weeks? I am very worried about leukemia.
Should I go directly to a hematologist? Thank you for your help.

Niming, 30~39 year old female. Ask Date: 2019/09/19

Dr. Hong Yuanbin reply Internal Medicine

Hello, regarding the lymphocyte part, since I don't have the exact numbers, I infer from your description that what the doctors mentioned is likely a higher "lymphocyte percentage" rather than an increase in lymphocyte count.
The lymphocyte percentage can vary due to different bodily conditions, which is a normal physiological phenomenon.
It is only concerning if both the total white blood cell count and the lymphocyte percentage rise simultaneously, and based on your description, that does not seem to be the case.
Therefore, it is unlikely to be leukemia.
Instead, considering your age, it is unlikely that you would experience hypokalemia and jaundice.
I recommend monitoring your liver, gallbladder, and gastrointestinal health for any issues.
Thank you for your inquiry.

Reply Date: 2019/09/19

More Info

Elevated lymphocyte levels can indeed be concerning, especially when one is worried about conditions like leukemia. However, it is essential to understand that elevated lymphocytes, or lymphocytosis, can occur for various reasons, and not all of them are indicative of a serious condition like leukemia.

Lymphocytes are a type of white blood cell that plays a crucial role in the immune system. They help the body fight infections and respond to foreign invaders. An increase in lymphocyte count can be a normal response to infections, particularly viral infections, or it can be due to other benign conditions such as stress, allergies, or even certain medications. In your case, the elevated lymphocyte count was noted alongside other symptoms, such as dizziness and nausea, which led to further investigations.

The fact that your doctors have conducted multiple tests, including ultrasound and endoscopy, and found no significant abnormalities is a positive sign. It suggests that they are not currently concerned about a severe underlying condition. The gastrointestinal issues you experienced, such as nausea and vomiting, could be related to a variety of factors, including stress or a viral infection, rather than leukemia.

Regarding your specific concern about leukemia, it is important to note that leukemia typically presents with a more complex set of symptoms and laboratory findings. Common signs of leukemia can include persistent fatigue, frequent infections, unexplained bruising or bleeding, and significant changes in blood counts, including not just elevated lymphocytes but also abnormalities in other types of blood cells. If your lymphocyte levels were significantly elevated, along with other concerning symptoms, further evaluation by a hematologist would be warranted.

In your situation, since your doctors have reassured you that the elevated lymphocyte count is not a cause for immediate concern and have scheduled a follow-up blood test in a month, it may be best to follow their advice. If you continue to feel unwell or if new symptoms arise, it would be prudent to seek further evaluation, potentially from a hematologist, who specializes in blood disorders. They can perform a more detailed analysis of your blood and, if necessary, conduct additional tests such as a bone marrow biopsy to rule out any serious conditions.

In summary, while elevated lymphocyte counts can be alarming, they are not always indicative of leukemia. Your doctors have conducted appropriate evaluations and have not found evidence to suggest a serious condition at this time. It is essential to maintain open communication with your healthcare providers, express your concerns, and follow their recommendations for monitoring your health. If you have ongoing worries, do not hesitate to seek a second opinion or ask for a referral to a specialist for further peace of mind.

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