Conversation: The conversation between human and AI assistant.
[|Human|] Dr Vineet, my name is Daniel Nicolae from Romania. I contacted you because i strongly need your oppinion regarding my blood analysis interpretation. I am diagnosticated with thalassemia major since i was 9 months old. Before Nov 2008 my stats was good. 2 packs of blood every 4 weeks. My Hb level pre-trans 8-8.5, and after transf 10.5-11 ....sometimes even 12.Well in November i changed to my chelator from Desferal to Exjade.  My ferritine level before exjade was around 2200.In the first weeks everything seemed to be fine. I was monitored weekly. After a few months i started to feel tired......I EVEN WAS SLEEPING IN THE AFTERNOON ( i almost never sleep in the afternoon).Then my Hb level started to drop. Before transf. my Hb level 6-6.5. I started to take 2 packs every 3 weeks. Still my post-transf Hb level doesnt pass 8.5-9 ...... AFTER 3 PACKS OF BLOOD WITH 220ml each! Then i changed to 3 packs every 2 weeks. The same result! Before transf Hb=6 and after 9 at most! My doctors didnt say anything! They even were frustrated that i asked for extra blood! They said to remove my spleen!In November 2010 doing some blood tests, my White Blood Cell counts were 3.2L ( normal range 4.0 - 9.0 ). Once i stopped Exjade, at my next blood tests my WBC=5.2L. My pre-trasnf. Hb level was now 7-7.5, and after transfusion 9.5-10 and even 11.6 after 3 packs of blood!Now i am on Desferal, as my chelator. But yesterday after my last transfusion my WBC was again 3.4L this time. I need to know what is happening to me, because my doctors only says that i should remove my spleen! I need your proffesional oppinion!Thank you very much! I will email my blood results from November, thouse with WBC = 3.2L at  YYYY@YYYY  if this is right, and specify that are mine!
[|AI|]  Dear Canal, although your question is directed to some other doctor, I would like to comment. Due to thalassemia, your spleen size will increase. After a critical size [variable person to person], spleen will start accumulation all blood cells. Whenever your transfusion need is so high with no other apparent reason, it's an indication to think for spleen removal.what's your age now? Why don't you discuss for BMT with your doctor?