Low iron???

[jointpain]

My wife's Hgb is often low, though can pickup a little after a ferinject IV. Her hematologist would prescribe ferinject when her ferritin was lower than 15, so she is always on the low side of normal. A recent trip to Christie's and blood tests gave this result above. We understand the ferritin numbers and considering she had recently had a ferinject prior to this test, can see why it is at 56. The Iron in yellow we don't understand and see it is low, but what exactly is it? Christie's have asked her hematologist to give my wife another ferinject IV ASAP, but that was only made known to us last week, and due to a recent blood test showing her Hgb has dropped again.Any thoughts on Iron at 3 umol/L??

[hunter5582]

Managing anemia can be a real challenge with MF. Ferritin (iron in storage) is only one of the numbers that needs to be considered. The entire iron panel needs to be evaluated to create an accurate picture. Your wife needs to get a detailed explanation from a MPN specialist.

Here is some basic information on the iron panel numbers.

• Serum iron. This test measures the amount of iron in your blood.

• Serum ferritin. This test measures how much iron is stored in your body. When your iron level is low, your body will pull iron out of “storage” to use.

• Total iron-binding capacity (TIBC). This test tells how much transferrin (a protein) is free to carry iron through your blood. If your TIBC level is high, it means more transferrin is free because you have low iron.

• Unsaturated iron-binding capacity (UIBC). This test measures how much transferrin isn’t attached to iron.

• Transferrin saturation. This test measures the percentage of transferrin that is attached to iron.

webmd.com/a-to-z-guides/iro...

Reference Ranges. Note that may vary by lab.

Ferritin 15.0 - 200.0 ng/mL

Iron 50.0 - 212.0 mcg/dL

Iron Binding Capacity 250.0 - 425.0 ug/dL

Iron, % saturation 20.0 - 50.0 %

Iron Binding Capacity 250.0 - 425.0 mcg/dL

Iron Binding Capacity (unsaturated) 155.0 - 355.0

There is no question she needs the recommended treatment ASAP, as Christie's indicates. This is the short-term priority

There are different ways to approach iron deficiency/anemia with MF. Suggest that your wife needs to review ALL of her options for managing the issues she is having with her MF.

Wishing you both all the best.

[jointpain in reply to hunter5582]

Thank you hunter, I hoped you might answer, though most went over my head. Luckily my wife is now being overseen by one of the most highly rated mpn consultants in the UK, he phones us up at home and emails us and the hematology department, today her blood counts were normal except Hgb was 99 but that had gone up a touch from last week. He wants the ferinject to increase her stored iron which he hopes will increase her Hgb more than before when her hematologist was happy to have it barely above low normal or too low. She's just starting her fourth week of Ruxolitinib tomorrow and taken no Anagrelide since she started Ruxolitinib but still taking hydroxycarbamide this is to decrease during the next few weeks we hope to zero.

All the best, and thanks for your reply.