From the Guidelines
Complete blood counts (CBCs) are not always abnormal in lymphoma, as some individuals with early-stage or indolent lymphomas may present with completely normal blood counts 1. When abnormalities do occur, they can include anemia, thrombocytopenia, leukopenia, or leukocytosis, depending on whether the bone marrow is involved and the specific type of lymphoma. For example, some lymphomas like chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are characterized by a progressive accumulation of leukemic cells in the peripheral blood, bone marrow, and lymphoid tissues, which may be reflected in CBC results 1. However, the absence of CBC abnormalities does not rule out lymphoma, which is why additional diagnostic tests like imaging studies, lymph node biopsies, and bone marrow examinations are essential for diagnosis. Key points to consider include:
- The type of lymphoma and its stage can influence the presence and nature of CBC abnormalities
- Normal CBC results do not exclude the possibility of lymphoma
- Comprehensive diagnostic workup is necessary for accurate diagnosis and management of lymphoma.
From the Research
Hematologic Abnormalities in Lymphoma
- Hematologic parameters, such as anemia, leukopenia, thrombocytopenia, leukocytosis, and thrombocytosis, can be abnormal in patients with lymphoma 2.
- The presence of bone marrow involvement by lymphoma is more likely to be associated with leukopenia and thrombocytopenia than the absence of bone marrow involvement 2.
- Anemia is present in 42% of patients with non-Hodgkin's lymphoma at diagnosis, while leukocytosis is present in 26% of patients 2.
Complete Blood Counts (CBCs) in Lymphoma
- CBCs are not always abnormal in lymphoma, as some patients may have normal hematologic parameters at diagnosis 2.
- The presence of abnormal hematologic parameters, such as anemia or leukocytosis, can provide useful prognostic information and may have therapeutic implications 2.
- A thorough evaluation of hematologic parameters, including CBCs, is essential in the diagnostic workup of lymphoma 3.
Diagnostic Evaluation of Lymphoma
- The diagnostic workup of lymphoma involves a variety of specimens, including lymph node biopsies, bone marrow biopsies, and peripheral blood smears 3.
- Ancillary diagnostic testing, such as flow cytometry and molecular studies, can help guide the diagnosis and classification of lymphoma 3.
- The American Society for Clinical Pathology and the College of American Pathologists have developed evidence-based guidelines for the preanalytic phase of testing in the diagnostic evaluation of lymphoma 3.