Analysis of Hypochromic Reticulocytes and Ferritin Index As a Rationale for an Effective Therapy of Cancer- and Chemotherapy-Associated Anemia

Introduction: In most cancer patients anemia will be attributable to the mechanisms of chronic disease compounded by the myelotoxic effect of chemotherapy. Nevertheless it is important to exclude alternative explanations such as iron deficiency before starting therapy with erythropoiesis stimulating agents (ESA). Recently Thomas et al. (Clin Chem 2002; 48:1066-76) combined the reticulocyte hemoglobin (Hb) content (CHr) with the C-reactive protein (CRP)-dependent ferritin (Fer) index (FI: soluble transferrin receptor/ log Fer ratio) in a diagnostic plot (DP). We conducted a prospective phase II trial to analyze the diagnostic value of CHr, FI and the DP in anemic chemotherapy treated cancer patients (pts).