What is the role of lab testing in the workup of follicular lymphoma?

Updated: Mar 03, 2020
  • Author: Lauren C Pinter-Brown, MD; Chief Editor: Emmanuel C Besa, MD  more...
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A complete blood cell count (CBC) and differential should be obtained, along with examination of the peripheral blood smear if the differential is abnormal. Frequently, abnormal lymphocytes can be identified in the blood smear, reflecting involvement of the blood

Blood chemistries, including lactate dehydrogenase (LDH) levels, uric acid levels, liver function tests, and creatinine measurements should be assessed. LDH is an indicator of tumor load, and an elevated level is a negative prognostic factor.

Hyperuricemia may be observed upon presentation or during therapy. Allopurinol should be considered in patients with hyperuricemia and before treatment to prevent uric acid nephropathy.

Increased creatinine levels can be observed in patients with renal obstruction caused by lymphadenopathy, and increased alkaline phosphatase and bilirubin measurements can be observed in patients with biliary obstruction due to lymphadenopathy or involvement of the liver.

If treatment with rituximab is being considered, serology for hepatitis B (ie, hepatitis B surface antigen, core antibody, and surface antibody) and hepatitis C should be obtained.

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