Tantawy Azza A, Ragab Iman A, Ismail Eman A, Ebeid Fatma S E, Al-Bshkar Ramadan M
Departments of Pediatrics.
Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
J Pediatr Hematol Oncol. 2020 Apr;42(3):e147-e151. doi: 10.1097/MPH.0000000000001700.
Cancer-related anemia is a common complication of cancer and its treatment that may be mediated by nutritional deficiency or inflammatory cytokines inhibiting erythropoiesis.
We evaluated the value of reticulocyte hemoglobin content (Ret He) as a marker of iron availability for erythropoiesis in childhood cancer and the impact of oral iron supplementation on hematologic parameters in patients with low Ret He.
This prospective study included 100 pediatric patients with cancer on chemotherapy who were screened for the presence of anemia. Patients with anemia underwent testing for complete blood count including Ret He on Sysmex XE 2100 and assessment of reticulocyte count, serum iron, serum ferritin, transferrin saturation, total iron-binding capacity, and C-reactive protein. Patients were classified according to their level of Ret He into normal or low Ret He using a cutoff level of 28 pg. Patients with low Ret He were subjected to 6 weeks' treatment with oral ion and were followed up with complete blood count and iron profile.
Thirty-one (77.5%) patients had normal Ret He, and 9 (22.5%) had low Ret He. Ret He was positively correlated with red cell indices, but not with iron parameters. After oral iron supplementation, a significant increase in hemoglobin, reticulocyte count, and iron was found.
We suggest that Ret He could be used as an easy and affordable tool for the assessment of iron deficiency anemia in childhood cancer during chemotherapy treatment. A trial of oral iron in patients with low Ret He may be useful to correct the associated anemia.
癌症相关性贫血是癌症及其治疗常见的并发症，可能由营养缺乏或抑制红细胞生成的炎性细胞因子介导。
我们评估了网织红细胞血红蛋白含量（Ret He）作为儿童癌症红细胞生成中铁可用性标志物的价值，以及口服铁剂补充对Ret He低的患者血液学参数的影响。
这项前瞻性研究纳入了100例接受化疗的儿科癌症患者，对其进行贫血筛查。贫血患者接受全血细胞计数检测，包括在Sysmex XE 2100上检测Ret He，并评估网织红细胞计数、血清铁、血清铁蛋白、转铁蛋白饱和度、总铁结合力和C反应蛋白。根据Ret He水平，使用28 pg的临界值将患者分为Ret He正常或Ret He低。Ret He低的患者接受6周的口服铁剂治疗，并进行全血细胞计数和铁代谢指标随访。
31例（77.5%）患者Ret He正常，9例（22.5%）患者Ret He低。Ret He与红细胞指数呈正相关，但与铁参数无关。口服铁剂补充后，血红蛋白、网织红细胞计数和铁显著增加。
我们建议Ret He可作为化疗期间评估儿童癌症缺铁性贫血的一种简便且经济的工具。对Ret He低的患者进行口服铁剂试验可能有助于纠正相关贫血。
