How can anemia be effectively treated in patients with low hemocrit and RBC count that is not due to iron deficiency? Patient has Medicare, but Procrit is not covered.
This essentially is two issues:
Cancer has received more focus in the world of anemia in the past couple of years and what is covered and what is not by Medicare. There is Procrit coverage, but only after the hbg has dropped below a certain number. Use of Procit isn't suggested unless iron stores have been secured first. This leads to the second issue.
Iron stores in cancer are hard to assess and many times there is confusion over how to do it. Namely; ferritin measurement becomes unreliable during this process of inflammation and tissue growth. There are other measurements that can be done to help in the attempt to assess iron stores such as transferrin, transferrin saturation, soluble transferrin receptors, etc. Therefore, make sure that someone hasn't looked at just ferritin in assessing these stores.