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Using the hemoglobin content of reticulocytes (RET-He) to evaluate anemia in patients with cancer.

Using the hemoglobin content of reticulocytes (RET-He) to evaluate anemia in patients with cancer.

American journal of clinical pathology (2014-09-23)

Ellinor I B Peerschke, Melissa S Pessin, Peter Maslak

ABSTRACT

Evaluation of anemia, particularly iron deficiency, in patients with cancer is difficult. This study examined using the hemoglobin content of reticulocytes (RET-He) to rule out iron deficiency, as defined by serum iron studies (transferrin saturation <20%, serum iron <40 μg/dL, and ferritin <100 ng/mL), in an unselected cancer patient population. Patients were entered into the study based on the existence of concurrent laboratory test requests for CBC and serum iron studies. Using a threshold of 32 pg/cell, RET-He ruled out iron deficiency with a negative predictive value (NPV) of 98.5% and 100%, respectively, in the study population (n = 209) and in a subpopulation of patients with low reticulocyte counts (n = 19). In comparison, the NPV of traditional CBC parameters (hemoglobin, <11 g/dL; mean corpuscular volume, <80 fL) was only 88.5%. These results support the use of RET-He in the evaluation of iron deficiency in a cancer care setting.

MATERIALS

Product Number

Brand

Product Description

Sigma-Aldrich

Iron, puriss. p.a., carbonyl-Iron powder, low in magnesium and manganese compounds, ≥99.5% (RT)

Iron, IRMM^®, certified reference material, 0.5 mm wire

Sigma-Aldrich

Iron, foil, thickness 0.1 mm, ≥99.9% trace metals basis

Sigma-Aldrich

Iron, chips, 99.98% trace metals basis

Sigma-Aldrich

Ferritin from human spleen, Type V, 10 μg/mL in 0.15 M NaCl, 10 mM Tris, pH 8.0, containing 0.1% sodium azide

Sigma-Aldrich

Ferritin from equine spleen, Type I, saline solution

Iron, foil, light tested, 25x25mm, thickness 0.05mm, hard, 99.5%

Iron, foil, 6mm disks, thickness 0.5mm, hard, 99.5%

Iron, foil, 50mm disks, thickness 0.25mm, hard, 99.5%

Iron, foil, light tested, 100x100mm, thickness 0.025mm, as rolled, 99.99+%

Iron, foil, 8mm disks, thickness 0.05mm, as rolled, 99.99+%

Iron, foil, 6mm disks, thickness 0.125mm, hard, 99.5%

Iron, foil, not light tested, 100x100mm, thickness 0.005mm, 99.85%

Iron, foil, 50mm disks, thickness 0.38mm, hard, 99.5%

Iron, foil, light tested, 25x25mm, thickness 0.075mm, hard, 99.5%

Iron, foil, 6mm disks, thickness 0.020mm, 99.85%

Iron, foil, light tested, 100x100mm, thickness 0.025mm, hard, 99.5%

Iron, foil, 6mm disks, thickness 0.125mm, as rolled, 99.99+%

Iron, foil, 8mm disks, thickness 0.05mm, hard, 99.5%

Iron, foil, not light tested, 100x100mm, thickness 0.007mm, 99.85%

Iron, foil, 6mm disks, thickness 0.007mm, 99.85%

Iron, foil, 50mm disks, thickness 0.5mm, hard, 99.5%

Iron, foil, 8mm disks, thickness 0.020mm, 99.85%

Iron, foil, light tested, 300x300mm, thickness 0.075mm, hard, 99.5%

Iron, foil, 8mm disks, thickness 0.38mm, hard, 99.5%

Iron, foil, 8mm disks, thickness 0.003mm, 99.85%

Iron, foil, 6mm disks, thickness 0.004mm, 99.85%

Iron, foil, 50mm disks, thickness 0.1mm, hard, 99.5%

Iron, foil, light tested, 25x25mm, thickness 0.05mm, as rolled, 99.99+%

Iron, foil, light tested, 100x100mm, thickness 0.038mm, hard, 99.5%