Do I have either of these?

[M51970]

I was diagnosed with low platelets (60,000) 8 years ago. A marrow biopsy was negative as well as a muriad of tests for auto immune diseases including lupus. All of my other cell counts were normal. To this day my platelets have fluctuated anywhere from in the 60,000's to the low 100,000's. I still have had no other symptoms. Is it still possible to have a lymphoma or leukemia with no treatment and no other symptoms after this long? Could the marrow biopsy have been a false negative?

[worrynurse]

IM NOT HAVING ANY SYMPTOMS THAT WOULD HAVE SPURRED ME TO HAVE A CBC DONE...JUST MY YEARLY.. THEN A REPEAT....BUT... I DO HAVE OCCASIONAL FLUSHING ON MY FACE AND OCCASIONALLY SWEATY AT NIGHT ALTHOUGH IT IS SUMMER...I MAY OR MAY NOT BE STARTING MENOPAUSE. I HAVE AN APPOINTMENT WIHT A HEME/ONC THIS WEEK...
THANKS FOR YOUR REPLY
DONNA

[Dennis MD]

Hi Donna,
What symptoms are you experiencing now?
You had two examinations which showed thrombocytopenia or decrease in platelet count.  As I’ve mentioned in my previous post, thrombocytopenia can be caused by any of the following mechanisms:  decrease in bone marrow production, increased splenic sequestration, or accelerated destruction of platelets.  
Any of the options you mentioned is feasible.  You may want to have a repeat blood examination in another reputable laboratory facility and see if the platelet count is indeed decreased.  You may also want to consult a hematologist for evaluation.
Regards.

[worrynurse]

I HAD TWO LOWER COUNTS (PLATELETS) OVER 2 MONTHS BUT IT WAS ONLY SLIGHTLY DECREASED 110.000 AND 132,000. (LAB NV 150,000 TO 400,000). IM 42 YO. DO YOU THINK THIS WOULD BE A GOOD ENOUGH REASON TO F/U WITH HEMATOLOGIST OR SHOULD I WAIT AND RE-CHECK COUNTS IN A COUPLE OF MONTHS?
DONNA

[Dennis MD]

Hi.
Thrombocytopenia or decrease in platelet count can be caused by any of the following mechanisms:  decrease in bone marrow production, increased splenic sequestration, or accelerated destruction of platelets.  
Initial evaluations or work-ups to determine the cause of thrombocytopenia include a peripheral blood smear, bone marrow aspiration and biopsy, and palpation of the spleen for enlargement.  
Thrombocytopenia can be an initial manifestation of systemic lupus erythematosus (SLE).  You mentioned that you were tested negative for SLE.  Other causes should be determined.
Do you have an enlarged spleen?  Do you have any bleeding signs and symptoms?  Are you taking any medications?
In a patient with normal spleen and normal bone marrow biopsy, excess destruction can be the reason for the decrease in platelet count.  Immune causes, drugs (chemotherapeutic agents, antibiotics, heparin, or cardiovascular drugs) can cause thrombocytopenia.  There is also a condition called chronic idiopathic thrombocytopenic purpura (chronic ITP).  This is an indolent form of thrombocytopenia and can persist for many years.
I would suggest consult with a hematologist for further evaluation.  One the cause of the thrombocytopenia is known, appropriate treatment will follow.
Good luck.