[tytd]

Hi Mcgill54,
Thanks for asking how I am managing. I have been doing OK with platelet counts ranging from 18 to 20k over the past 8 months. I've talked my MD into only getting them checked every 3 months as long as I call him if I have any signs of bleeding which I have not. I feel OK doing this since the pace of my drop has been very slow. I have the usual easy bruising and petechiae and watch for any mucosal bleeding in nose or mouth. I have a mild to moderate anemia with Hb of about 9.7 which I tolerate OK.
I'm sorry to hear that your count has dropped to 37k, but you never know, it might plateau. Generally if it's above 20k one should be OK but of course that depends on the individual patient. I, of course, in my case, do not agree with the threshold of transfusing everybody with a platelet count below 20k. That would seem to be reasonable if it is dropping fast or if you have any bleeding, fever, infection, or coagulation problems, etc. I think you just have to "play it by ear" and assess the whole patient not just the "number". Did you have any chromosomal abnormalities on your BMB? I had read where Gleevac had been used in some patients with CMML with a particular translocation but that's probably mainly in patient's with an elevated WBC. I'm sure your MD is familiar with that. Have you had B12 level checked? Hope you will continue to do well. Tytd