HNY Policy and Pathway Repository - North Yorkshire

Raised lymphocytes

None provided

Causes

• Smoking
• Viral infections especially Glandular fever
• Lymphoproliferative disorders (such as CLL)
• Bacterial infections
• Post-splenectomy
• Rheumatoid arthritis

Lymphocytosis >5 x 10⁹/L

Refer urgently (suspected cancer) to haematology if:

• Lymphocytosis >20 x 10⁹/L
• Other cytopenias
• B symptoms
  • Weight loss >10% over 6 months
  • Drenching sweats
  • Unexplained fever > 38°C
• Lymphadenopathy
• Splenomegaly

If lymphocytosis >5-20 x 10⁹/L then repeat FBC in 6 weeks and look for causes:

• Refer routinely to haematology if persistently >10 x 10⁹/L
• Consider A&G in first instance if <10 consider repeat FBC in 6-12 months - if remains elevated

• Harrogate and District