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Home > Cancers We Treat > Hematologic Cancer > LGL Leukemia Program > LGL (Large Granular Lymphocyte) Leukemia

LGL (Large Granular Lymphocyte) Leukemia

A graphic depicting large granular lymphocytes (LGLs) with pink granules that appear larger than other white blood cells.
Large granular lymphocytes (LGLs) appear larger than
other white blood cells and have pink granules.
Large granular lymphocyte leukemia (LGL) is a rare form of blood cancer. Only an estimated 1,000 new cases appear in the U.S. each year.

LGLs in Your Blood

In normal blood, 10-15 percent of white blood cells or lymphocytes are large granular lymphocytes (LGLs).

LGLs have a characteristic appearance (see image). Larger than normal lymphocytes, they contain pink granules. Part of the normal immune system, LGLs fight viruses.

Too Many LGLs

Large granular lymphocyte leukemia results from having too many LGLs in your blood; either more LGLs than normal, or a higher percentage, compared to other types of white blood cells.

Types & Features 

Two types of LGL leukemia can occur:

  • T-cell 
  • NK-cell 

T-cell LGL Leukemia

A chronic disease, this type of leukemia:

  • Usually occurs in people between 50 and 60     
  • Causes anemia half the time
  • Results in an enlarged spleen half the time

Patients often have recurring bacterial infections, rheumatoid arthritis and neutropenia.

NK-cell LGL Leukemia

NK-cell LGL leukemia comes in two forms, chronic and acute. The chronic form has similar features to T-cell LGL leukemia.

The acute form occurs rarely, but happens rapidly. Most patients: 

  • Experience systemic symptoms, like fever and weight loss
  • Have massive enlargement of the liver and spleen
  • Get anemia 
  • Suffer from severe neutropenia
  • Die within two months of diagnosis

Symptoms of Both LGL Leukemia Types

  • Repeated infections
  • Frequent fevers
  • Night sweats
  • Unintended weight loss
  • Weakness


LGL leukemia can be diagnosed by conducting several tests, including:

  • Complete blood count (CBC), usually first test to show the main sign of LGL leukemia, high white blood cell count and low neutrophil count
  • Flow cytometry with an LGL Panel, which can show what type of LGL leukemia is present
  • T-cell receptor gene rearrangement (TCR) further tests for types of T-cell clones 
  • Bone marrow biopsy
  • Splenectomy and spleen analysis 


  • Splenectomy (removal of the spleen)
  • Blood transfusions (to treat anemia)



Make an Appointment

To make an appointment please call 434.924.9333

Articles, Videos & Podcasts

Read an article about UVA Cancer Center Director Thomas Loughran, Jr. who played a leading role in the discovery of Large Granular Lymphocyte (LGL) Leukemia.