Q. My LDH levels are rising, and my lymphocyte count is dropping. Does this indicate lymphoma?

Hi doctor,

I have a rising LDH level which went to 227 U/L and three months later to 269 U/L. In the last two CBC tests, lymphocytes dropped to 0.8 per mcL. I am concerned if it could be lymphoma. I had prostate cancer 15 years ago and a nodule in my lung. Two years before, I had a total PET/CT with tracers. I do not have night sweats or swollen nodes. Can you review my attached blood work, please?

Hi doctor,

Thanks for the reply.

What do absolute lymphopenia and relative neutrophilia mean? Will CRP and ESR tests show where the infection is? Also, I am getting an LDH isoenzymes test. Will that be good to pinpoint the condition better?

Hi doctor,

Thanks for the reply.

I will try to get these tests. So do you think it is improbable to be lymphoma, leukemia, or severe disease?

Hi doctor,

Thanks for the reply.

The LDH has gone down to 232 U/L. But the concern is the lymphocytes dropped from 0.8 per mcL in the last test to 0.7 per mcL. Should I be concerned or not? Would you recommend further tests? I feel fine. I have attached the reports, and all other blood tests are normal in CBC.

Hi doctor,

Thanks for the reply.

I do not have any symptoms. I am an athlete, so I exercise hard. I have osteoarthritis and had radiation therapy five years ago for prostate cancer. But no medications and no fever. Do you think I do not have anything serious? Any further blood tests to take? All my other CBC looks great. I did have an LDH isoenzymes test, but it takes two weeks for results to come.

Hi doctor,

Thanks for the reply.

I looked back at my WBC and lymphocyte trends in lab tests, telling a hematological story. Four years before, my lymph count fell to 0.8 per mcL along with WBC to 3.9 mcL. Then both rose to normal again. Two years before, my lymph count fell to 0.7 per mcL and WBC as well, then rose to normal. Now my lymph count is at 0.7 mcL and WBC to 4.5 mcL. I assume this rise and fall shows a trend in my body. I feel it is not a disease as it would rise back to normal each time. Am I correct?

Hi doctor,

Thanks for the reply.

So am I correct in saying that it is an external factor rather than some disease? As my body overcomes the external factor, my counts return to normal each time, whereas, in a condition, it would not. Am I correct?

Hi doctor,

Thanks for the reply.

I have attached my LDH isoenzymes result. Can you comment whether L1 to L5 all look within limits? Anything abnormal with my lymphocytes dropping? My doctor wants to test again before seeing a hematologist. Including CBC, I think a blood smear is a good idea. Is there anything else that would help the hematologist?