Low platelets otherwise normal CBC with diff

[Bchittineni]

Hi all, I was diagnosed in 2016. My cbc with diff was wnl except a plt count of 29k. Initially diagnosed with ITP then a bone marrow that year showed CLL stage 0 with ITP; I am 13q and mutated. I had 4 rounds of rituxan in 2016 and put on high dose steroids starting at 60mg qd and tapering down to7.5mg qd. My platelets bounce between 40 to 60 (rarely 80k) and went as low as 35k. I contributed the 35k to prevnar and hepatitis B vaccinations. My local oncologist who consults with a CLL specialist (Dr. Venugopal in Chicago) wants me to do another 4 rounds of rituxan for the ITP. I am leaning against it as my WBC is 9.3 (on steroids) hgb is 12.7 and my ALC is 1.6 and absolute neuts are wnl too. Most recent plt count was 45k the month before was 60k. I don't want the rituxan to tank my neuts and lymphocytes. recent liver and spleen ultrasounds were normal (no enlargement). I think I should stay on prednisone 7.5 mg and alternate with 5mg rather than do the rituxan. Any opinions would be greatly appreciated.

[Bchittineni]

I forgot to put I am 47 yrs old...

[seelel]

I have faced something similar to you a couple of times - please PM me as I have some information to pass on.

[Bchittineni in reply to seelel]

Thanks!...I am a computer moron...how do I PM you?

[hazelview10]

I too have ITP with CLL diagnosed in 2004. My platelets dropped to 2 on a couple of occasions!! Treatment with steroids was very effective but you don’t want to be on them long term. In 2005, with falling platelets, before the invention of Rituxan, I had a splenectomy which was very successful, and I had FCR in 2012. My platelets now tick along at about 140. You must take advice from your specialist. I don’t think splenectomy is advised these days.

Unfortunately I am on steroids again for another condition probably related to CLL and the steroids have led to osteoporosis. You don’t want this or the risk of diabetes.

Good luck, John