Erythropenia



blood.jpgErythropenia is a deficiency of red blood cells or erythrocytes. Remember your blood is made up of red blood cells, white blood cells and plasma.

Your normal blood test, CBC or complete blood count assesses the number of red cells in a drop of your blood.

HCT and HGB? The hematocrit tells how much space your red blood cells are occupying and signal anemia if this number is too low. Hemoglobin are the oxygen transporter pigment portion of the red blood cells. They are formed by the immature erythrocytes in your bone marrow.

Normal HCT and HGB levels:

Hematocrit:

  • Men 45-57 %
  • Women 37 -47%

Hemoglobin:

  • Men 14 -18 grams per 100 milliliters of blood
  • Women 12-16 grams per milliliters of blood

Erythropenia is a condition where a cancer patient has an abnormally low red blood cell count or anemia.

Anemia is generally diagnosed when your CBC shows your hemoglobin levels are below 11 g/dL.

Symptoms of anemia:

  • fatigue
  • weakness
  • shortness of breath
  • coldness or numbness in extremities
  • dizziness
  • irritableness
  • headaches
  • pale skin

An anemia symptom quiz is available at the National Anemia Action Council site. Take the quiz and then discuss it with your doctor.

Causes of anemia in cancer patients:

  • Blood loss
  • Bone marrow destruction due to types of cancers
  • Side effect of radiation or chemotherapy which destroys red blood cell production
  • Side effect of tumor activity also destroying red blood cell production
  • Decreased levels of erythropoietin, a hormone produced in the kidney and liver which assists red blood cell production

Treatment of Erythropenia is based on diagnosis and exploration of the underlying cause. Most cancer patients will develop anemia during or after treatment. 80 percent will develop serious anemia.

Treatment options include:

  • Erythrocyte Growth Factor, Erythrocyte Stimulating Agent (ESA): a synthetic form of erythropoietin, a colony-stimulating factor. It is injected to increase red cells and the hemoglobin level. The generic name is epoetin alfa and the brand names include, Epogen and Procit. The longer lasting version of Epogen is called Aranesp. It takes several days for this treatment to show an increase in blood tests, so if the levels are low a transfusion may be the best option per your doctors evaluation.
  • Blood transfusions- See more on blood transfusions and donating blood at the Battling Cancer archives. Donated blood can be saved and utilized for up to forty-two days or if frozen for a maximum of ten years.

It should be noted that an FDA warning issued in 2007 has highlighted the increase reports of side effects due to ESA usage. There is much debate regarding the topic and the use of ESAs in the medical community. Articles of interest are included in the resources section.
Resources:

The National Anemia Action Council : Improving the Lives of People With Anemia

FDA Votes To Limit ESA Cancer Use to Metastatic Patients

National Cancer Institute Bulletin

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.
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