patient in the infusion center

LGL Leukemia Program

Large granular lymphocyte (LGL) leukemia is a rare form of blood cancer, with fewer than 1,000 new cases diagnosed in the U.S. each year. Because it's so rare, doctors often overlook or misdiagnose the disease.

UVA Cancer Center specializes in the diagnosis and treatment of LGL leukemia. Here you'll find the latest in:

  • Research-based care
  • Knowledge of advanced therapies
  • Access to state-of-the-art facilities, supportive care and ancillary services

The LGL Program at UVA

More than 30 years ago, UVA Cancer Center director Thomas P. Loughran, Jr., MD discovered LGL leukemia. Since then, Loughran has dedicated his research and clinical focus to understanding this rare disease. View LGL program transcript.

Help Us Find a Cure

Support our efforts to find potential cures for LGL leukemia: Make a gift today. 

LGLs in Your Blood

In normal blood, 10-15% of white blood cells or lymphocytes are large granular lymphocytes (LGLs). LGLs have a characteristic appearance. Larger than normal lymphocytes, they contain pink granules. Part of the normal immune system, LGLs fight viruses.

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)