Prevalence and aetiology of anaemia in lymphoid malignancies.
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Date
2013-03
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Abstract
Background. We prospectively studied the prevalence,
type and causes of anaemia in newly diagnosed patients with
lymphoid malignancies.
Methods. Between January 2007 and June 2008, a total
of 316 newly diagnosed, consecutive patients (aged 15 years
or above) of Hodgkin lymphoma, non-Hodgkin lymphoma
and chronic lymphocytic leukaemia with anaemia (haemoglobin
<11 g/dl), were analysed to determine the prevalence and a
subgroup of 46 patients was analysed for the cause of anaemia.
Results. Hodgkin lymphoma, non-Hodgkin lymphoma
and chronic lymphocytic leukaemia were the diagnoses in 81
(25.8%), 203 (64.7%) and 30 (9.6%) patients, respectively.
Anaemia was present in 134 patients (42.4%). Anaemia of
chronic disease was present in 33/46 (71.7%) and iron
deficiency in 18/46 (39.1%) patients. Vitamin B12 and/or
folate deficiency was detected in 10/46 (21.7%) patients
(B12 deficiency alone in 7, folate deficiency alone in 1 and
combined B12 and folate deficiency in 2). Autoimmune
haemolytic anaemia was detected in 5/46 (10.9%) although
direct Coombs test was positive in 17/46 (37%) patients.
Among patients with Hodgkin lymphoma and non-Hodgkin
lymphoma, anaemia due to bone marrow involvement was
present in 16/40 (40%). In most patients with bone marrow
involvement, anaemia was due to other causes. In only 3
patients, anaemia was attributable to bone marrow involvement
alone. Anaemia was multifactorial in 18/46 (39.1%) patients.
Nutritional deficiency alone or in combination was present in
22/46 (47.8%) patients.
Conclusion. Anaemia is common in lymphoid malignancies
at initial presentation. Besides managing anaemia of chronic
disease and bone marrow involvement, nutritional and
autoimmune causes should be ruled out.
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GHOSH J, BIKRAMJIT SINGH R K, SAXENA R, GUPTA R, VIVEKANANDAN S, SREENIVAS V, RAINA V, SHARMA A, KUMAR L. Prevalence and aetiology of anaemia in lymphoid malignancies. National Medical Journal of India. 2013 Mar-Apr ; 26 (2): 79-81.