title: Using the hemoglobin content of reticulocytes (RET-He) to evaluate anemia in patients with cancer.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Patients were entered into the study based on the existence of concurrent laboratory test requests for CBC and serum iron studies.
  
  
  RESULTS
  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%.
  
  
  CONCLUSIONS
  These results support the use of RET-He in the evaluation of iron deficiency in a cancer care setting.
authors.affiliation: From the Memorial Sloan-Kettering Cancer Center, New York, NY, and Weill Cornell Medical College, New York, NY. peersche@mskcc.org.
authors.forename: Ellinor I B
authors.initials: EI
authors.lastname: Peerschke
authors.affiliation: From the Memorial Sloan-Kettering Cancer Center, New York, NY, and.
authors.forename: Melissa S
authors.initials: MS
authors.lastname: Pessin
authors.affiliation: From the Memorial Sloan-Kettering Cancer Center, New York, NY, and Weill Cornell Medical College, New York, NY.
authors.forename: Peter
authors.initials: P
authors.lastname: Maslak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D004909:Erythrocyte Indices; D005260:Female; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007223:Infant; D007501:Iron / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000150:complications; D012156:Reticulocytes / Q000378:metabolism*; D012680:Sensitivity and Specificity; D014168:Transferrin / Q000032:analysis; D055815:Young Adult
chemical_list: D006454:Hemoglobins; D014168:Transferrin; D005293:Ferritins; D007501:Iron
keywords: Anemia; Cancer; Hematology; Iron deficiency; RET-He