What are the common laboratory abnormalities associated with lymphoma?

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Last updated: May 8, 2025 • View editorial policy

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From the Guidelines

Laboratory abnormalities in lymphoma patients often include complete blood count (CBC) abnormalities, elevated lactate dehydrogenase (LDH), and increased erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), which are crucial for diagnosis, staging, and monitoring treatment response. These abnormalities can be seen in various lymphoma subtypes, including Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) 1. According to the European recommendations for cytogenomic analysis of haematological neoplasms, specific lymphoma subtypes may show characteristic genetic abnormalities, such as t(11;14) in mantle cell lymphoma and t(14;18) in follicular lymphoma 1.

Some common laboratory findings in lymphoma patients include:

  • Anemia, thrombocytopenia, and leukopenia or leukocytosis on CBC
  • Elevated LDH, which serves as a marker of tumor burden and cell turnover
  • Increased ESR and CRP, reflecting the inflammatory state associated with lymphoma
  • Abnormal liver function tests, particularly elevated alkaline phosphatase, if there is liver involvement
  • Hypercalcemia, especially in aggressive lymphomas
  • Monoclonal gammopathy on serum protein electrophoresis in certain lymphoma types
  • Elevated beta-2 microglobulin, which serves as a prognostic marker
  • Increased uric acid levels due to increased cell turnover

Specific lymphoma subtypes may also show characteristic abnormalities, such as:

  • Elevated interleukin-6 in Castleman disease
  • HTLV-1 antibodies in adult T-cell lymphoma
  • t(8;14) in Burkitt lymphoma
  • t(11;18) in extra nodal marginal zone lymphoma of mucosa-associated lymphoid tissue

These laboratory findings, while not diagnostic on their own, provide valuable information for diagnosis, staging, and monitoring treatment response in lymphoma patients 1. It is essential to integrate laboratory results with histological reports, immunophenotype, and other genetic abnormalities to ensure accurate diagnosis and treatment planning.

From the Research

Lab Abnormalities with Lymphoma

  • Lymphoma is a group of malignant neoplasms of lymphocytes with more than 90 subtypes, and it can present with various lab abnormalities 2
  • Common laboratory findings in new lymphoma patients include elevated aspartate aminotransferase, prothrombin time (PT), lactate dehydrogenase (LDH), lactic acidosis, and cytopenia 3
  • Anemia is a common feature in newly diagnosed lymphoma patients, with anemia of chronic disease being the most common cause 4
  • The frequency of anemia in lymphoma patients can be as high as 45%, with anemia of chronic disease accounting for 33.1% of cases, followed by anemia secondary to marrow involvement (27.17%), iron deficiency anemia (7.6%), Vitamin B-12 deficiency anemia (1.6%), and hemolytic anemia (0.54%) 4
  • Erythropoiesis-stimulating agents (ESAs) can be used to manage anemia in lymphoma patients, but their use should be carefully considered due to potential risks and benefits 5, 6
  • Functional iron deficiency is a common hindrance to response to ESA treatment, and the use of intravenous iron can improve the response rate of ESA treatment 6

Specific Lab Abnormalities

  • Elevated lactate dehydrogenase (LDH) is a common lab abnormality in lymphoma patients, particularly those with diffuse large B-cell lymphoma (DLBCL) 3
  • Cytopenia, including anemia, thrombocytopenia, and leukopenia, can occur in lymphoma patients due to bone marrow involvement or other factors 3, 4
  • Prothrombin time (PT) can be elevated in lymphoma patients, particularly those with advanced disease or those who have received chemotherapy 3

Management of Lab Abnormalities

  • The management of lab abnormalities in lymphoma patients should be individualized based on the specific abnormality, the underlying disease, and the patient's overall condition 2, 6
  • Erythropoiesis-stimulating agents (ESAs) can be used to manage anemia in lymphoma patients, but their use should be carefully considered due to potential risks and benefits 5, 6
  • Iron supplementation can be used to manage iron deficiency anemia in lymphoma patients, and intravenous iron can be used to improve the response to ESA treatment 6

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

2
Research

Lymphoma: Diagnosis and Treatment.

American family physician, 2020

4
Research

Frequency and causes of anemia in Lymphoma patients.

Pakistan journal of medical sciences, 2019

6
Research

Managing anemia in lymphoma and multiple myeloma.

Therapeutics and clinical risk management, 2008

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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