ACRT Journal

Surviving Extreme Anemia (Hemoglobin <30g/L) in Patients Older Than 75 Years

Abstract

We present an 82-year-old female patient surviving extreme anemia with a hemoglobin of 29 g/l. The patient was suffering from chronic anemia due to chronic myelomonocytic leukemia with hemoglobin values between 80-100 g/l, treated with monthly injections of darbepoetin alfa. The acute worsening occurred due to a bleeding ulcer in the gastrointestinal tract. Transient renal dysfunction was the only organ manifestation the patient was treated with 5 units of packed red blood cells and surgery. She survived without sequelae. We speculate, that chronic anemia and the administration of an erythropoietin derivative induced adaptive processes on the cellular level enabling survival without permanent organ injury. In the literature, we found only two reports of patients >75-years of age with a hemoglobin <30 g/l, of which one survived and the other died. Hence, further studies are needed to generate information on incidence, baseline characteristics or mortality rates in patients older than 75 years with extreme anemia.

Keywords: Severe Anemia; Extreme Anemia; Low Hemoglobin; Ulcer; Bleeding.