Symptoms of High Lymphocytes (Lymphocytosis)

Lymphocytes are white blood cells responsible for fighting infection. When the number of lymphocytes in your blood is significantly higher than normal, doctors refer to it as lymphocytosis. This condition is often detected during routine blood tests and may not show any visible symptoms. However, some people may experience signs and symptoms that indicate high lymphocytes.

“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. They are part of your body's immune system that protects you from illness and disease. In most cases, lymphocytosis is not a serious condition. However, if the underlying cause is not identified and addressed, it can lead to more severe health issues.

Whether you experience symptoms depends on how high your lymphocyte count is, said Dr. Rogers. Some people have lymphocyte counts only slightly higher than the normal range and don't have any symptoms, while others may experience one or more of the following:

Fatigue

It's common to feel unusually tired when your blood cell counts are abnormal. Fatigue is a symptom of many medical conditions, including anemia, sleep disorders, and depression. However, it can also be a sign of high lymphocytes. When the body is fighting an infection or illness, it may divert energy resources from other areas to support the immune system, leading to fatigue.

If you're experiencing chronic fatigue along with other symptoms of high lymphocytes, it's essential to consult with your doctor to determine the underlying cause. A complete blood count (CBC) is often one of the first tests ordered to evaluate a new onset of fatigue, as it can provide valuable information about your blood cell counts, including your lymphocytes.

Fever

Some people with high lymphocytes experience a fever due to an underlying infection or inflammation. A fever is the body's natural response to fighting infection. If your lymphocyte count is high, your immune system may be working overtime to fight off illness or disease.

Most fevers last just a few days, but if your fever persists or is accompanied by other symptoms, you should see your doctor immediately. A fever lasting longer than a few days or one that comes and goes over the course of several weeks or months could be a sign of a more severe underlying condition.

Poor Appetite

Your appetite may be affected by illness or infection. You may feel less hungry than usual or struggle to eat enough food due to nausea, vomiting, or diarrhea. Eating fewer calories can lead to weight loss, weakness, and fatigue.

Chronic lymphocytic leukemia (CLL) and other lymphocytic disorders can also cause appetite changes due to enlarged organs. When cancer cells accumulate inside the lymph nodes, spleen, or another organ, they can cause swelling and discomfort, making eating and digesting food challenging.

Weight Loss

Weight changes in response to lymphocyte disorders can be unpredictable. Some people may experience weight loss due to reduced appetite and other side effects related to treatment, while others may gain weight due to increased fluid retention and enlarged organs.

Weight loss can also occur due to the body's response to inflammation caused by high lymphocyte levels. Chronic inflammation can lead to muscle wasting as the body breaks down protein stores for energy, which also leads to weight loss.

Enlarged Lymph Nodes

The lymphatic system is a network of vessels and nodes that help your body eliminate toxins and waste. Your lymph nodes can swell and become tender when your lymphocytes are actively working to fight off an infection or disease. Sometimes, lymph nodes temporarily swell for no apparent reason. Other times, swollen lymph nodes may indicate a more serious underlying condition.

See your doctor for a physical exam if you notice enlarged lymph nodes in your neck, underarms, or groin area that don't go away within a week or two. Swollen lymph nodes can indicate infection, inflammation, or cancer. A CT scan or biopsy may be necessary to determine the cause.

Night Sweats

Night sweats refer to episodes of excessive sweating that occur while you sleep. You may fall asleep comfortably but wake up a few hours later feeling sweaty. Night sweats are most commonly associated with infections, hormonal imbalances, and cancer.

Elevated lymphocyte levels can trigger night sweats as your body's immune response increases your body's temperature to fight off infection or disease. Tara Graff, DO, MS, a medical oncologist with Mission Cancer and Blood in Des Moines, previously told Patient Power that night sweats in CLL are a sign that your B lymphocytes, which produce antibodies to fight off viruses and bacteria, have gone into "overdrive" and are working harder than they should be.

Enlarged Spleen

Your spleen is an organ located in your upper left abdomen. It helps filter blood and fight infection. In some cases, high lymphocyte levels can cause the spleen to enlarge. This can be a sign of an underlying condition such as CLL or other lymphocytic disorders.

An enlarged spleen can cause discomfort or pain in your upper abdomen, especially when you take deep breaths. You may also become full more quickly when eating. In severe cases, an enlarged spleen can rupture and cause life-threatening internal bleeding.

Infection is the most common cause of an enlarged spleen, so your doctor may order blood tests to check for viruses or bacteria. They may recommend a CT scan or ultrasound to help determine the cause.

CLL and High Lymphocytes

Elevated lymphocyte levels can be a sign of CLL. CLL is a cancer that starts in the blood and bone marrow.

"It represents about 1% of all cancers," said Milan Sheth, MD, a physician with MemorialCare Todd Cancer Institute at Long Beach Medical Center in Long Beach, California, who is quadruple board certified in internal medicine, hematology, oncology, and palliative care.

If you have CLL, you may be concerned if your blood test reveals 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's a good idea to understand what it means.

With CLL, your bone marrow produces too many abnormal lymphocytes. The cancerous cells eventually crowd out the healthy cells and accumulate in the blood and bone marrow. Since the diseased cells don't undergo a natural death as healthy cells do, your blood work may show a high lymphocyte count. The cancer cells can also prevent your body from producing enough healthy red blood cells, white blood cells, and platelets.

While many people with CLL don't have symptoms, some experience fatigue, weight loss, enlarged lymph nodes, and night sweats.

CLL can cause a significant increase in lymphocytes, but there are many other possible causes as well. These include:

• Acute lymphoblastic leukemia (ALL)

• Asplenia (absence of spleen function)

• Autoimmune conditions (lupus, rheumatoid arthritis)

• Babesiosis

• Brucellosis

• Cat-scratch disease

• Certain medications (corticosteroids, anticonvulsants)

• Cytomegalovirus (CMV) infection

• Epstein-Barr virus (EBV) infection (causes mononucleosis)

• Hepatitis A

• Hepatitis B

• Hepatitis C

• HIV/AIDS

• Hypothyroidism (underactive thyroid)

• Influenza

• Large granular lymphocytic leukemia

• Lymphoma

• Mumps

• Non-Hodgkin lymphoma

• Shingles

• Smoking

• Splenectomy (removal of the spleen)

• Syphilis

• Toxoplasmosis

• Tuberculosis

If you recently had blood work and the lab report indicates that you have lymphocytosis, it’s important not to panic. High lymphocyte levels can be temporary in response to the flu or another infection, or they may be a sign of something more serious like CLL.

If your doctor is concerned about your elevated lymphocyte level, they may recommend further testing. This could include a repeat blood test, imaging scans, or a biopsy if cancer is suspected. It's important to follow up with your doctor and discuss any concerning symptoms or changes in your health.

"CLL represents a very indolent disease where patients can continue to live a normal life span despite the diagnosis," Dr. Sheth said. "Often, it's observed or monitored and not treated." When treatment is necessary, your doctor may recommend targeted therapy or immunotherapy.

"We have moved almost completely away from chemotherapy and instead use targeted therapies such as a Bruton tyrosine kinase inhibitor or a BCL2 inhibitor, both of which are oral therapies," said Dr. Sheth. "These drugs can be combined with an IV immunotherapy or anti-CD20 therapy to enhance the efficacy of the oral drugs."

The five-year relative survival rate for people with CLL is 88.5%, according to the National Cancer Institute's SEER database. And since CLL is primarily seen in older adults, many people with the condition die from old age rather than the disease. Medication and treatment advances continue to give people with CLL a better chance of managing their disease and living a longer life.