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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, powder, −325 mesh, 97%

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 0.075mm, hard, 99.5%

Iron, foil, light tested, 150x150mm, thickness 0.075mm, hard, 99.5%

Iron, foil, light tested, 50x50mm, thickness 0.025mm, hard, 99.5%

Iron, foil, 300x300mm, thickness 0.1mm, hard, 99.5%

Iron, tube, 1000mm, outside diameter 12.0mm, inside diameter 10mm, wall thickness 1.0mm, annealed, 99.5%

Iron, rod, 50mm, diameter 5.0mm, as drawn, 99.99+%

Iron, foil, 25x25mm, thickness 2mm, as rolled, 99.99+%

Iron, foil, 50x50mm, thickness 0.5mm, hard, 99.5%

Iron, foil, 300x300mm, thickness 0.20mm, hard, 99.5%

Iron, tube, 100mm, outside diameter 10.6mm, inside diameter 10.0mm, wall thickness 0.3mm, as drawn, 99.8+%

Iron, foil, 100x100mm, thickness 0.125mm, hard, 99.5%

Iron, rod, 100mm, diameter 30mm, as drawn, armcO« soft ingot 99.8%

Iron, rod, 50mm, diameter 12.7mm, as drawn, 99.95%

Iron, tube, 500mm, outside diameter 12.7mm, inside diameter 9.5mm, wall thickness 1.6mm, annealed, 99.5%

Iron, wire reel, 100m, diameter 0.065mm, hard, 99.5%

Sigma-Aldrich

Iron, nanopowder, 35-45 nm particle size, 99.5% trace metals basis

Iron, rod, 300mm, diameter 6.0mm, as drawn, 99.99+%

Iron, foil, 150x150mm, thickness 0.38mm, hard, 99.5%

Iron, foil, 1m coil, thickness 0.38mm, hard, 99.5%

Iron, foil, 25mm disks, thickness 0.005mm, 99.85%

Iron, foil, 1m coil, thickness 0.1mm, hard, 99.5%

Iron, foil, 50mm disks, thickness 0.05mm, hard, 99.5%

Iron, rod, 100mm, diameter 2.0mm, as drawn, 99.99+%