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The blood count typically shows decreased numbers of blood cells—including a decreased number of circulating red blood cells, white blood cells, and platelets. The bone marrow may show hemophagocytosis. The liver function tests are usually elevated. A low level of the protein albumin in the blood is common. [citation needed]
In general, a bone marrow biopsy is part of the "work up" for the analysis of these diseases. All specimens are examined microscopically to determine the nature of the malignancy. A number of these diseases can now be classified by cytogenetics (AML, CML) or immunophenotyping (lymphoma, myeloma, CLL) of the malignant cells. [citation needed]
Lymphoproliferative disorders are a set of disorders characterized by the abnormal proliferation of lymphocytes into a monoclonal lymphocytosis. The two major types of lymphocytes are B cells and T cells , which are derived from pluripotent hematopoietic stem cells in the bone marrow .
Lymphocytosis is an increase in the number or proportion of lymphocytes in the blood.Absolute lymphocytosis is the condition where there is an increase in the lymphocyte count beyond the normal range while relative lymphocytosis refers to the condition where the proportion of lymphocytes relative to white blood cell count is above the normal range.
Although lymphocytes are usually considered mature, as seen in blood tests, they are certainly not inert. Lymphocytes can travel around the body wherever there is a need. When such needs arise, new rounds of downstream lymphopoiesis, such as cell multiplication and differentiation, may occur, accompanied by intense mitotic and metabolic activity.
Individuals with MBL usually present with unexplained increases in blood lymphocyte counts (i.e. lymphocytosis). The most common causes for lymphocytosis are viral infections, autoimmune diseases (particularly connective tissue diseases), hypersensitivity reactions, acute stress reactions, and prior splenectomy. [9]
Most often the lymphocyte count is greater than 5000 cells per microliter (μL) of blood but can be much higher. [13] The presence of lymphocytosis in a person who is elderly should raise strong suspicion for CLL, and a confirmatory diagnostic test, in particular flow cytometry, should be performed unless clinically unnecessary. [37]
The excessive immature lymphocytes in the bone marrow interfere with the production of new red blood cells, white blood cells, and platelets. [1] Diagnosis is typically based on blood tests and bone marrow examination. [3] Acute lymphoblastic leukemia is typically treated initially with chemotherapy aimed at bringing about remission. [2]