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,

The fall in platelets and hemoglobin are not so abrupt that one needs

to be particularly worried, but you have crossed that " magic

threshold " of 100,000 (or 100) platelets. Given this drop, it is

necessary to perform this evaluation in order to assess you needs for

treatment.

Rick Furman, MD

>

> I have attached to this email an excert of my last 6 months of

blood work

> (including charts which makes easier reading). Just in case some

members

> feel nervous about opening the attachment, I have appended the key

numbers

> below:

>

>

>

>

>

>

> 12/08/2007

>

> 11/10/2007

>

> 23/11/2007

>

> 15/02/2008

>

> 30/03/2008

>

>

> HB

>

> 14.3

>

> 13.2

>

> 14.1

>

> 12.7

>

> 12.3

>

>

>

>

> 12/08/2007

>

> 11/10/2007

>

> 23/11/2007

>

> 15/02/2008

>

> 30/03/2008

>

>

> Whites

>

> 6.3

>

> 6.6

>

> 7.9

>

> 7.8

>

> NK

>

>

>

>

> 12/08/2007

>

> 11/10/2007

>

> 23/11/2007

>

> 15/02/2008

>

> 30/03/2008

>

>

> Platelets

>

> 118

>

> 125

>

> 137

>

> 104

>

> 79

>

>

>

>

> 12/08/2007

>

> 11/10/2007

>

> 23/11/2007

>

> 15/02/2008

>

> 30/03/2008

>

>

> Neuts

>

> 3.7

>

> 3.1

>

> 3.3

>

> 3.3

>

> NK

>

>

>

>

> 12/08/2007

>

> 11/10/2007

>

> 23/11/2007

>

> 15/02/2008

>

> 30/03/2008

>

>

> Lymphs

>

> 1.8

>

> 3.1

>

> 4.2

>

> 4.1

>

> 2.6

>

>

>

> I am now 25 months post Rituxan and Chlorambucil which has served me

> extremely well, but symptoms have returned over recent months. My

story is

> somewhat complicated in that I have found myself without a

Haematologist in

> recent months until yesterday when I meet my new Haematologist for

the first

> time. She was very meticulous in her examination of my previous

history and

> of myself, so I feel quite confident that I can work with her going

forward.

> She ordered a battery of blood tests, including CD38 and FISH to

recheck my

> markers before any future treatment. She even called me later in

the day to

> say that she had taken a look at some of my blood results and she

was

> concerned about the failing HB and Platelets and in view of this

she has

> scheduled me for a more blood tests, BMB and CT Scan. She was

concerned

> that my CLL has transformed into something more aggressive, or ITP,

or a

> viral activation such as CMV.

>

>

>

> Over the last 6 months my health has been a little up and down,

muscle and

> joint pains in the lower limbs, tiredness and fatigue.

>

>

>

> My questions is two fold, (i) do you feel that my Haematologist is

just

> being cautious in ordering these additional tests and (ii) do my

blood

> results demonstrate that something serious is going on, other than

just a

> marrow that's becoming a little compacted and therefore restricting

the

> production of normal cell lines.

>

>

>

> Appreciate any views you may have and maybe Dr Furman might be able

to pass

> comment.

>

>

>

> Regards

>

>

>

>

>

> UK, Bournemouth. Dx May 2000. Age 51. Oral Fludarabine 2002. 4

weeks of

> Rituxan June 04 and Jan 05. Oct 05/Feb 06 monthly Rituxan and

Chlorambucil.

> Trisomy 12, IgVH mutated, ZAP70 -ve, CD38 -ve.

>

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