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Anemia — a decrease in the level of hemoglobin and red blood cells in the blood.

Anemic syndrome, which occurs during chemotherapy courses for cancer of the gastrointestinal tract, requires careful diagnosis to determine the cause of anemia. It is necessary to examine the patient even with a slight decrease in the level of hemoglobin, since often anemic syndrome reduces the quality of life of the patient, reduces the effectiveness of chemotherapy and in a certain number of cases is the reason for its cancellation.



The first symptoms of anemia are pallor of the skin and mucous membranes, rapid fatigue, shortness of breath during physical exertion. In most patients, a decrease in hemoglobin is accompanied by a further violation of the function of the gastrointestinal tract: loss of appetite, a feeling of chronic nausea, frequent vomiting. The progression of the main oncological disease with concomitant anemia syndrome is accompanied by a gradual deterioration in general well-being. There is a constant general malaise, muscle weakness and loss of performance.



General and biochemical blood tests, as well as a timely full examination with a study of ferrostatus, analysis of the level of vitamin B12, folic acid and endogenous erythropoietin - allow you to detect changes in these indicators in time. If the iron-deficient nature of anemia is excluded, a cytological examination of the bone marrow is performed, which clarifies the cause of anemia. If specialists in the study detect hematopoietic dysplasia, simultaneously with a high level of serum iron in the blood serum, then the appointment of iron preparations for the correction of the anemia syndrome is canceled.


Treatment tactics

The treatment strategy for anemia of the myelodysplastic state of the bone marrow depends on the level of hemoglobin and red blood cells. Patients with a hemoglobin level of 100-90 g / l and red blood cells of 3.6-2.5 million require administration of erythropoietin-type drugs. In turn, patients with low levels of these indicators - with hemoglobin below 85 g/l, and red blood cells less than 2.5 million, require hemotransfusion therapy with red blood cells containing blood components.

Thus, timely detection of hematopoietic dysplasia is necessary to avoid mistakes in the treatment of anemic conditions of oncological diseases of the gastrointestinal tract. The unjustified and uncontrolled use of publicly available iron preparations, vitamin B12, and other B vitamins is often not only ineffective, but also brings great harm to the patient. And maintaining a low hemoglobin concentration (less than 90 g / l) can contribute to the progression of the tumor disease and reduce the effectiveness of antitumor treatment. 

The necessary examination by a hematologist to clarify the cause of anemia in patients with oncological diseases of the gastrointestinal tract is possible in the outpatient CDO of the State Medical Institution of the Moscow State Medical Center named after A. S. Loginov DZM.


GBUZ Moscow Clinical Scientific Center named after Loginov MHD