The GP for this patient refers her to the outpatient clinic when bloods, repeated at 3 months, showed the lymphocyte count had increasd to 14. The patient also complained of sweats.

Question:

 Medical students/junior docs – How do you decide whether or not the ‘sweats’ are likely to be due to CLL? What other symptoms would be of interest?

Haematologists –  The patient has a medical relative who has advised her that she should have ‘special tests’ to provide prognostic information. We suggest you only answer one of the following: What tests might this relative be referring to? Would you do these? How would you counsel the patient about the implications of such investigations?