Hi @philipschuyler. Chronic lymphocytic leukemia is generally a very slowly developing form of leukemia. Frequently CLL is found randomly through bloodwork with routine physicals because of the lack of symptoms in the initial stages. Often people can go years without any treatment until symptoms become more pronounced such as night sweats, low grade fever, fatigue, unexplained weight loss, swollen lymph nodes, changes in blood counts, etc..

It’s usually not necessary to have a bone marrow biopsy (bmbx) to diagnose CLL. Though a bmbx may be helpful confirming the diagnosis or evaluating the extent of the disease. Also, unless there’s a specific area of the body your oncologist is concerned about checking, such as a swollen lymph node, a CT isn’t commonly used. As fellow member @ppolockaz mentioned, a PET scan would be more commonly used than a CT.

You asked what would happen if you did nothing at all. That is your prerogative as a patient. I’m not sure it’s warranted to find a new oncologist at this time. But it is important that you’re comfortable with your doctor and feel they can relate to your concerns regarding the BMBX and CT.
Much of the treatment going forward depends on what your blood work shows and the potential for your CLL to progress. Your doctor may use the BMBX to help stage your CLL.
If this were me, my next step would be to contact the doctor for a consultation and discuss the concerns. Ask why you need the tests. Ask if staging has been done for your disease or if the BMBX would be helpful.

Here’s a link to the Mayo informational article on CLL: https://www.mayoclinic.org/diseases-conditions/chronic-lymphocytic-leukemia/symptoms-causes/syc-20352428

Do you have any swollen lymph nodes that your doctor physically felt? Have you experienced any symptoms related to CLL that you’re aware of?