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  • Immunosuppression

    • HIV, certain infections
    • steroids, chemorad, fludarabine, cladribine
    • congenital immunodeficiency
    • systemic dz or debilitation
  • Flow to r/o lymphoma

    • HIV testing if CD4:8 ratio decreased
    • marrow bx if
      • monoclonal B cells
      • slg negative mature B cells
      • aberrant T cells
      • increased blasts
    • moniter if
      • no monoclonal B, aberrant T, or increased blasts
      • if clinical concern persists, future repeat CBC may be considered