When is it time to begin CLL treatment?

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Question from Gene:   
When is it time to treat CLL? Does a low platelet count trump WBC count? When is a low platelet count significant?

Answer from Dr. Leclair:
The standard classification for staging CLL is:

•   Rai stage 0: Lymphocytosis and no enlargement of the lymph nodes, spleen, or liver, and with near-normal red blood cell and platelet counts.

•   Rai stage I: Lymphocytosis plus enlarged lymph nodes. The spleen and liver are not enlarged, and the red blood cell and platelet counts are near normal.

•   Rai stage II: Lymphocytosis plus an enlarged spleen (and possibly an enlarged liver), with or without enlarged lymph nodes. The red blood cell and platelet counts are near normal.

•   Rai stage III: Lymphocytosis plus anemia (too few red blood cells), with or without enlarged lymph nodes, spleen or liver. Platelet counts are near normal.

•   Rai stage IV: Lymphocytosis plus thrombocytopenia (too few blood platelets), with or without anemia, enlarged lymph nodes, spleen or liver.

In your situation, the issue would be the definition of "near normal". Some take into consideration whether or not there are concerns about inappropriate bleeding (gum bleeding, nose bleeds, easy bruising, etc.), while others look only at the numbers. You need to find out from your physician what he/she will take into account here. I suspect that 125 is not "low enough" for therapy at this time, but I do not know your other issues such as frequency of illnesses, node size, etc.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Have a question for the experts? Send them to questions@patientpower.info.

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Page last updated on February 19, 2016