Anemia is a fairly common condition in medical practice. Complaints such as fatigue, paleness, or dizziness are often attributed to low blood levels due to a busy diet or activity level. In many cases, anemia is mild and can improve with simple treatment.
However, in certain situations, anemia can be an early indicator of a more complex medical condition, including lymphoma. Understanding the link between anemia and lymphoma helps ensure a more competent and accurate evaluation.
How Is Anemia Related to Lymphoma?
Lymphoma is a disease that originates in the lymphatic system, part of the immune system. In some lymphoma patients, anemia may be found as a concomitant condition, not a cause.
The link between anemia and lymphoma can occur through several mechanisms, including:
- Bone Marrow Production Disorders: Lymphoma cells can infiltrate the bone marrow, taking up space that would otherwise be used to produce red blood cells, resulting in decreased red blood cell counts (anemia).
- Anemia of Chronic Disease: Lymphoma can cause the body to produce inflammatory cytokines that prevent iron from being used in the formation of new red blood cells, known as anemia of chronic disease.
- Treatment Side Effects (Chemotherapy): Chemotherapy for lymphoma (such as the CHOP/R-CHOP regimen) can cause a decrease in hemoglobin levels, resulting in anemia.
- Blood Cell Destruction (Hemolytic Anemia): In some cases of lymphoma, the immune system may mistakenly destroy its own red blood cells.
- Prognostic Factors: The presence of anemia in lymphoma patients, particularly in cases of Non-Hodgkin Lymphoma (NHL), is often considered a worse prognostic indicator or more advanced disease stage.
- Causes of Fatigue: Anemia caused by lymphoma often triggers symptoms of severe fatigue in patients.
Furthermore, the chronic inflammatory process that accompanies lymphoma can also affect blood cell formation and iron metabolism. In certain circumstances, decreased nutritional intake due to ongoing illness also plays a role.
The Role of Medical Examination in Assessing Anemia
In clinical practice, anemia is often detected through routine blood tests. The doctor will diagnose the type of anemia, its possible cause, and any other findings that require further evaluation.
If anemia is found along with signs suspected to be related to lymph node abnormalities, the doctor may recommend further tests as medically indicated. This step aims to obtain a correct diagnosis and determine the most appropriate treatment.
If anemia persists for a long time or is accompanied by other complaints that need to be evaluated, consulting a subspecialist in medical hematology oncology is the right step.
Article written by Dr. Ryan Ardian Saputra, Sp.PD (Internal Medicine Specialist, EMC Alam Sutera & Tangerang Hospital).