Diagnose correctly autoimmune or over crowded bone marrow

[buddyjo]

In Australia, how to correctly diagnose late stage Cll, infiltration from over crowded bone marrow, or autoimmune disease/ problem.

What test do we ask for ?

What markers are important ?

How do we find out if platelets been examined by a 'machine', or has a human eye been used ( platelets can clump together resulting in wrong platelet count )

Any input appreciated. Love this site. Hope and prayers for all of us connected by Cll.

Patient 33yrs, 8 years ago diagnosed. And yes this is very young.

Buddy jo

[AussieNeil Partner Administrator]

Hi Buddy Jo,

Being diagnosed quite young with CLL, you have done well to avoid needing treatment this long. I can understand why you are now wondering what could be causing your presumably falling platelet counts.

I expect your specialist would order the Coombs/DAT (Direct Antiglobulin Test) blood test to check for the auto-Immune Haeomolytic Anaemia (AIHA) if you have falling haemoglobin and platelets and there was any concern that it wasn't due to your CLL bone marrow infiltration. My (Australian) specialist did so over 7 years after my diagnosis, but given I had an enlarged spleen at diagnosis and my bone marrow biopsy that showed significant CLL infiltration, we knew that these would be the primary reasons for falling platelet and haemoglobin results over time.

With CLL, it's more important to track trends over time; one low platelet result could indeed be due to clumping causing the automated counting to undercount. If there was any concern by your doctor or specialist, then I would expect you would be asked to have another blood test done and perhaps a manual count.

Neil

[buddyjo in reply to AussieNeil]

A big thank you. I need and appreciate correct medical answer and terminology in order to be taken seriously by medical personnel.