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Cancer patients with anemia have lower numbers of red blood cells than normal. Red blood cells carry oxygen from the lungs to other parts of the body. Red blood cells develop in the bone marrow, which lies in the center of the bones.

Causes of anemia

Anemia may be caused by:

  • Chemotherapy that damages the bone marrow
  • Radiation to large areas of the body or to bones (damages the bone marrow)
  • Cancer of the bone marrow, including leukemia and lymphoma
  • Too much bleeding after surgery or internal bleeding caused by a tumor
  • Nausea, vomiting and loss of appetite – They can interfere with patients getting enough nutrients (such as iron, folic acid, and vitamin B12) needed to make red blood cells.

Symptoms of anemia

Signs and symptoms of anemia include:

  • Feeling very weak and tired (fatigue)
  • Dizziness or fainting
  • Shortness of breath
  • Fast heartbeat
  • Pale skin

Diagnosis of anemia

The doctor will get your child’s medical history, do a physical exam , and order laboratory tests like a complete blood count test (CBC). The CBC is a common way of diagnosing anemia and measures:

  • Red blood cells (RBC) - The numbers, size, and types of red blood cells
  • White blood cells (WBC) - The numbers and types of white blood cells
  • Platelets - The numbers and size of the platelets
  • Hemoglobin - An iron-rich protein in red blood cells that carries oxygen to the body’s tissues
  • Hematocrit (HCT or PCV) – How much space red blood cells take up in the blood compared to plasma and other cells
  • Reticulocyte count – Number of young red blood cells in the blood
  • Mean corpuscular volume (MCV) – The average size of red blood cells

Your child may have :

  • A low red blood cell count
  • Low levels of hemoglobin
  • Low hematocrit
  • Reticulocyte count that is higher or lower than normal, depending on the cause of anemia
  • MCV shows smaller-sized red blood cells

The doctor will compare your child’s test results with those from normal, healthy children and discuss them with you. Your doctor may order more tests to determine the type of anemia and its cause.

Anemia blood cell and normal blood cell graphic with white and red blood cells and platelets

If your child has anemia, their red blood cell count will be lower than normal in a complete blood cell count test (CBC).

Treatment of anemia

Your child’s treatment will depend on what is causing their anemia, and may Treatment may include:

  • Red blood cell transfusion – Your child may receive donated red blood cells. The provider may give the red blood cells Patients receive red blood cells by vein either through their your child’s central venous access device or a peripheral IV. This treatment is very common in cancer patients.
  • Medications – On rare occasions,In some rare cases, the care providers doctor may prescribe medicines that help your child’s body make more red blood cells.stimulate the production of red blood cells.
  • -Vitamin and mineral supplements – In very few cases, The doctor may the care team may recommend prescribe vitamin and mineral supplements. These will help your child make more red blood cells ( that support red blood cell production such as iron, , folic acid, and , or vitamin B12).

Managing anemia

Balance rest with activity. Try takingYou child can take short naps during the day balanced with some physical activitbalanced with some physical activity during the day. Keep in mind thatToo too much bed rest can make people your child feel weak.

Sleep Make sure your child gets the recommendedright amount of sleep time each day (including naps.): 

  • Infants, 12-16 hours
  • Ages 1-2 years, 11-14 hours
  • Ages 3-5 years,  10-13 hours
  • Ages 6-12 years, 9-12 hours
  • Ages 13-18 years, 8-10 hours

Talk to the care team about your child's diet. Healthy foods and drinks will help provide nutrients.

Key Points

  • Childhood cancer patients with anemia have lower numbers of red blood cells than normal.
  • Anemia symptoms include feeling weak or tired, dizziness, shortness of breath, fast heartbeat, and pale skin.
  • Your doctor will run tests like a complete blood count (CBC) to diagnose your child.
  • Your child’s treatment will depend on the cause of their anemia.

For more information

Reviewed: September 2022