Difference between revisions of "Anemia"
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Latest revision as of 11:31, 15 May 2024
- We have moved How I Treat articles to a dedicated page.
Guidelines
NCCN
- NCCN Guidelines - Cancer- and Chemotherapy-Induced Anemia
- 2012: Rodgers et al. Cancer- and chemotherapy-induced anemia. PubMed
- 2008: Rodgers et al. Cancer- and chemotherapy-induced anemia. PubMed
- 2003: Sabbatini et al. Anemia clinical practice guidelines in oncology. PubMed
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