Brief Answer: Followup Detailed Answer: This is an excellent question, It would be reasonable for your doctor to request a peripheral blood screening test for CLL which would include flow cytometry. This is a comprehensive panel and may include additional tests such as ZAP70 expression and mutation status of immunoglobulin heavy chain. Cytogenetics can also be requested from your blood to see if there are any active mutations. This would allow a pathologist to review your blood and render a diagnosis. Also a peripheral blood smear would be helpful - a pathologist can review this under a microscope to study for any abnormalities in your circulating white blood cells. I want to reassure you that even if this is CLL we have excellent treatments and many times patients do not need treatment for many years. It is also possible that this may not be CLL and I do not want to speculate until you obtain further testing. If the flow cytometry is abnormal then a formal consultation with a hematologist locally would be reasonable. Likely this is something which can we watched conservatively - but again we do not have enough information yet to render a diagnosis. Thanks again for sending the query. Let us know if we can be of any additional assistance. Sincerely, Dr. Galamaga

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