Difference between revisions of "Anemia"

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'''Use of this site is subject to you reading and agreeing with the terms set forth in the [[HemOnc.org_-_A_Hematology_Oncology_Wiki:General_disclaimer|disclaimer]].'''
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*''We have moved [[How I Treat]] articles to a dedicated page.''
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=Guidelines=
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==NCCN==
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*[https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1422 NCCN Guidelines - Cancer- and Chemotherapy-Induced Anemia]
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**'''2012:''' Rodgers et al. [https://doi.org/10.6004/Jnccn.2012.0064 Cancer- and chemotherapy-induced anemia.] [https://pubmed.ncbi.nlm.nih.gov/22570293/ PubMed]
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**'''2008:''' Rodgers et al. [https://doi.org/10.6004/Jnccn.2008.0042 Cancer- and chemotherapy-induced anemia.] [https://pubmed.ncbi.nlm.nih.gov/18597709/ PubMed]
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**'''2003:''' Sabbatini et al. Anemia clinical practice guidelines in oncology. [https://pubmed.ncbi.nlm.nih.gov/19795572/ PubMed]
  
==Initial evaluation==
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=Initial evaluation=
 
May consist of:
 
May consist of:
 
*CBC with differential, MCV
 
*CBC with differential, MCV
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*Medications
 
*Medications
  
===GI bleeding?===
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===GI bleeding or iron deficiency===
 
*Stool occult blood
 
*Stool occult blood
 
*EGD & colonoscopy
 
*EGD & colonoscopy
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*Celiac (TTG IgA)
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*H. pylori Ab, H. pylori stool antigen
  
 
===Hemolysis?===
 
===Hemolysis?===
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*Direct & indirect Coombs
 
*Direct & indirect Coombs
 
*LFTs (direct, indirect, total bilirubin)
 
*LFTs (direct, indirect, total bilirubin)
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*Infectious: anaplasma, babesia, ehrlichia
  
 
===Anemia of chronic disease/anemia chronic kidney disease===
 
===Anemia of chronic disease/anemia chronic kidney disease===
 
*Basic metabolic panel (BMP) & iron labs as above
 
*Basic metabolic panel (BMP) & iron labs as above
 
*Serum erythropoietin
 
*Serum erythropoietin
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*ESR
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*CRP
  
 
===Chronic/inherited?===
 
===Chronic/inherited?===
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*Copper
 
*Copper
 
*Zinc
 
*Zinc
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 +
[[Category:Hematology reference pages]]

Latest revision as of 11:31, 15 May 2024

  • We have moved How I Treat articles to a dedicated page.

Guidelines

NCCN

Initial evaluation

May consist of:

  • CBC with differential, MCV
  • Basic metabolic panel (BMP)
  • Liver function tests (LFTs)
  • Reticulocyte count
  • Iron, total iron binding capacity (TIBC), ferritin
  • Vitamin B12 +/- methylmalonic acid & homocysteine
  • Folic acid
  • TSH
  • Peripheral smear
  • Clinical history, lifestyle factors (e.g. alcohol)
  • Medications

GI bleeding or iron deficiency

  • Stool occult blood
  • EGD & colonoscopy
  • Celiac (TTG IgA)
  • H. pylori Ab, H. pylori stool antigen

Hemolysis?

  • LDH
  • Haptoglobin
  • Direct & indirect Coombs
  • LFTs (direct, indirect, total bilirubin)
  • Infectious: anaplasma, babesia, ehrlichia

Anemia of chronic disease/anemia chronic kidney disease

  • Basic metabolic panel (BMP) & iron labs as above
  • Serum erythropoietin
  • ESR
  • CRP

Chronic/inherited?

  • Hemoglobin electrophoresis
  • Sickle cell evaluation

Myeloma?

  • SPEP & IFE
  • UPEP
  • Free serum/urine kappa/lambda light chains
  • Skeletal survey

Primary marrow process/hematologic malignancy

Less common

  • Copper
  • Zinc