Abstract
Lymphocytosis may represent either a lymphoproliferative disorder (LPD) or a reactive process. The absolute lymphocyte count (ALC) threshold for further evaluation of lymphocytosis is not well established. We prospectively performed flow cytometry on blood samples from patients 50 years or older with ALCs of 4.0 × 109 cells/L or greater without a history of an LPD. Monoclonal B-cell populations were found in 34 (19.1%) of 178 cases, with incidence increasing with age. In patients younger than 75 years, no monoclonal B-cell population was identified in patients with ALCs less than 4.4 × 109 cells/L, while such clones were found below and above this threshold in patients 75 years and older. These findings support a threshold for smear review and flow cytometry no lower than 4.4 × 109 cells/L in patients younger than 75 years and a threshold as low as 4.0 × 109 cells/L in patients 75 years and older.
Published Version
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