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Gayle,
You're asking good questions but I don't know what the best answers are.
Getting a second opinion is usually helpful, because it either gives you another point of view or gives you more confidence when another doctor agrees. A good doctor should welcome second opinions, not object or feel threatened, and the Mayo Clinic is excellent. However, you can't get a second opinion on your daughter's bone marrow biopsy results because there wasn't enough of a sample, and a history of blood counts isn't going to tell them everything they'll want to know. Since insurance may also be an issue, you could start by asking Dr. Boxer if he's consulted with colleagues at Arizona Oncology or other institutions. You could also check with the Mayo Clinic's insurance department and see how your daughter's college insurance would apply to a consultation at the Mayo Clinic.
Your daughter's hypocellularity has certainly been confirmed, but that's preventing diagnosis of the underlying condition, or at least ruling out some of the possibilities. Dr. Boxer may have apologized but I don't think it's his fault that the sample had too few cells. The fewer cells there are, the worse the chances of getting enough cells for analysis.
If your daughter's counts continue to drop or remain very low, she may have little choice other than another biopsy. If she gets one, it should probably be from another section of bone, for example, left hip vs. right hip, but there's no guarantee of a good sample. Your daughter should insist on more painkillers or stronger painkillers and not suffer the same discomfort as the previous times. Many doctors don't pay enough attention to pain, and they understandably don't want to overmedicate a patient, but that means it's often up to patients to speak up.
You and your daughter should take her low platelets seriously. The doctors know better than us laypersons, but I'm surprised your daughter wan't told to avoid Ultimate Frisbee and mountain biking given her bleeding risk. Nobody wants to take away a student's enjoyment of college life, but you have to be realistic about the dangers of low blood counts.
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