A doctor suspects leukemia — but could the spleen be to blame for low platelets?

Dear Doctor Roach: I’m 80. Over the past 26 years, I’ve had low blood platelet counts. (In 1998, one reading was 168,000, and in 2026, the reading was 117,000.) I have an enlarged spleen (16.1 centimeters), and I understand that this could account for my low platelet count. I do have tiny red dots on my chest. However, my doctor thinks that I have leukemia and is preparing me for a spinal tap.