What Is a T-Cell Lymphoproliferative Disorder? Inside Halsey’s Diagnosis

• In a series of Instagram posts, Halsey shared that they were diagnosed with lupus and a T-cell lymphoproliferative disorder.
• A T-cell lymphoproliferative disorder is an umbrella term for a host of diseases related to the overproduction of lymphocytes.
• These conditions can be serious, but people may be able to reach remission with treatment.

Halsey, 29, was diagnosed and treated for both lupus and a rare white blood cell disorder, according to a series of recent Instagram posts.

The singer said they were first diagnosed two years ago with systemic lupus erythematosus (SLE), the most common form of the autoimmune disease.

Lupus can affect several parts of the body and can cause symptoms such as fatigue, joint pain, muscle aches, skin rashes, and sometimes organ dysfunction, Erik Peterson, MD, an immunologist and associate professor of medicine at the Center for Immunology at the University of Minnesota Medical School, told Health.

Following their lupus diagnosis, Halsey discovered they also had a T-cell lymphoproliferative disorder—an umbrella term for a host of diseases that are all related to the overproduction of a kind of white blood cell called lymphocytes.¹

“Long story short, I’m Lucky to be alive,” Halsey wrote in a post caption on June 4.

Halsey had a “rocky start” at the beginning of their illness—they posted a video of treatment that featured clips of the singer receiving medications via IV, lying in hospital beds, and crying.

Now on the other side of this treatment process, Halsey said they’re “feeling better” and their conditions are being managed. However, the singer noted the conditions are ones that they’ll “likely have for the duration of [their] life.”

Here’s what experts had to say about T-cell lymphoproliferative disorder, how it’s connected to lupus, and what it’s like living with and managing these diseases.

What Is a T-Cell Lymphoproliferative Disorder?

Despite the complex name, lymphoproliferative disorders have a relatively simple definition—the term encompasses any disorder where the body makes too many lymphocytes. In addition to higher concentrations of white blood cells, this can lead to swollen lymph nodes and issues with the normal function of bone marrow.²¹

Although many diseases technically fall under this umbrella, they’re split into two groups. A disease’s categorization depends on which of the two white blood cell types is affected: T-cells or B-cells.

“T-cell lymphoproliferative disorders include more than a dozen different diseases,” Changchun (George) Deng, MD, PhD, medical director of lymphoma and chronic lymphocytic leukemia at the University Hospitals Seidman Cancer Center in Cleveland, told Health.

And these numerous T-cell lymphoproliferative disorders can vary in severity, Deng explained. Some of them are more mild, while others are considered malignant, or cancerous.

Malignant disorders include T-cell lymphoma (a type of non-Hodgkin lymphoma), the blood cancer Sézary syndrome, and T-cell prolymphocytic leukemia, among others.³⁴⁵

However, in the case of Halsey, it’s not clear if they have a malignant or non-malignant form of T-cell lymphoproliferative disorder. The umbrella term does not automatically denote cancer, Deng emphasized.

“A diagnosis of T-cell lymphoproliferative disorder is not equivalent to T-cell lymphoma,” he said. “If there is enough evidence to make the specific diagnosis of T-cell lymphoma, typically the more general term of T-cell lymphoproliferative disorder may be avoided.”

What Is Lymphoma?

What Causes Lymphoproliferative Disorders? 

Due to the wide variety of conditions considered lymphoproliferative disorders, there are also several potential causes and risk factors.

Some people have lymphoproliferative disorders that stem from genetic mutations, said Jennifer Yeh, MD, PhD, a clinical assistant professor of dermatology and co-director of the dermatology-rheumatology multidisciplinary clinic at the Stanford University School of Medicine.

These mutations might be inherited or acquired at some point in a person’s life, she told Health.

Lymphoproliferative disorders are also more common in people who are immunocompromised.¹ Immunosuppression—which can happen when someone has an organ transplant or is taking drugs to suppress their immune system for some other reason—could somehow be related to this overproduction of white blood cells, Yeh said.

Though experts agree lupus and T-cell lymphoproliferative disorders aren’t commonly seen together, there is some evidence that the two could be linked in some way.

“One common feature of lupus is abnormal expansion of several types of white blood cells,” Peterson said. “These white blood cells have separate but critical roles in protecting the person from infection.”

You can imagine a well-functioning immune system like a car that can accelerate and brake as needed, Peterson said. But for people with both lupus and a T-cell lymphoproliferative disorder, that ability to stop is compromised, he explained.

The mechanism behind this immune dysregulation isn’t clear. One potential explanation is that both lupus and certain lymphoproliferative disorders have been linked to the Epstein-Barr virus (EBV).⁶ EBV is a common virus and typically mild, but in some people, it can raise the risk of cancer, chronic fatigue, neurological conditions, and autoimmune disorders.

However, despite all of these different possibilities, many people don’t end up with a clear explanation as to why they developed a T-cell lymphoproliferative disorder. Most often, “there may not be an obvious cause,” Deng said.

Managing Lymphoproliferative Disorders

People with T-cell lymphoproliferative disorders experience different symptoms based on the specific condition they have, Yeh said.

However, “common symptoms can include swollen lymph nodes, spleen or liver enlargement, elevated white blood cell counts, atypical bleeding or bruising, bone pain, fatigue, weakness, weight loss, night sweats, and frequent infections,” she said.

The general prognosis for this group of conditions is considered poor, but they can be treated and managed.¹

In situations where someone has a cancerous lymphoproliferative disorder, such as leukemia, “powerful medications to kill the malignant or uncontrollably expanding [white blood cells] are given,” Peterson explained. This could include anti-viral drugs or chemotherapy.

But if someone has a non-cancerous disorder, doctors will usually use drugs to suppress the immune system rather than kill white blood cells.

“Those immunosuppressive medications tend to slow down the metabolic, or the respiratory, or the cellular functions of these abnormal cells,” said Peterson.

Though these conditions can be life-threatening, thanks to improved treatments, it’s possible that patients with both lupus and T-cell lymphoproliferative disorders “[live] with near normal quality and quantity of life,” Peterson said. Outcomes are even better when the disease is caught and treated early, Yeh added, and some patients do reach remission.¹