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About Lymphoma

Anaemia

Our blood is made up of red blood cells, white blood cells, platelets and a fluid called plasma. Our red blood cells are the reason our blood is red, and they get their red colour from a protein called haemoglobin (Hb).

Anaemia can be a symptom of blood cancers, including some subtypes of lymphoma. It is also a very common side effect of cancer treatments such as chemotherapy and total body irradiation (TBI). Other causes of anaemia include low iron or vitamin B12 levels, kidney problems or blood loss.

On this page:

What you need to know about red blood cells & haemoglobin

Bone marrow

Red blood cells are made in our bone marrow – the spongey middle part of our bones, and then move into our blood stream.

Haemoglobin is a protein on our red blood cells that makes them red.

Oxygen attaches to the haemoglobin on our red blood cells when they pass through our lungs. The red blood cells then drop off the oxygen to every other part of our body when our blood flows through them.

As the red blood cells drop off the oxygen, they also pick up waste such as carbon dioxide from those areas. They then take the waste back to our lungs so we can breathe it out.

When blood flows through our kidneys, our kidneys detect how much red blood cells and oxygen we have. If this level is falling, our kidneys produce more of a hormone called erythropoietin. This hormone then stimulates our bone marrow to make more red blood cells.

Our red blood cells are the only cells in our body that do not have a nucleus. The nucleus is the part of a cell that carries our DNA and RNA.

Because they do not have a nucleus (or the DNA and RNA inside them) they are unable to replicate themselves (make another cell out of the original cell) or repair themselves when damaged.

Our bone marrow makes about 200 billion red blood cells every day, and each one lives for around 3 months. 

When needed, our bone marrow can increase the number of red blood cells it makes up to 8 times more than the usual amount.

What our red blood cells look like under a microscope

What is Anaemia?

Anaemia is the medical term for low red blood cells and haemoglobin. Chemotherapy is the main cause of anemia when you’re having treatment for lymphoma. This is because chemotherapy targets fast growing cells, and unfortunately, it cannot tell the difference between fast growing healthy cells and fast-growing cancerous cells. 

Remember above, we said that our bone marrow makes 200 billion red cells every day? That makes them an unintended target of chemotherapy.

When you’re anaemic you may get symptoms of low blood pressure due to having less cells in your blood, and symptoms of Hypoxia (low oxygen levels). Oxygen is needed by every cell in our body to have the energy it needs to function.

Symptoms of anaemia

  • Extreme tiredness and fatigue – This is different from normal tiredness and is not improved with rest or sleep.
  • Lacking energy and feeling weak all over.
  • Shortness of breath due to lower oxygen levels.
  • Fast heart rate and heart palpitations. This happens because your body is trying to get more blood (and therefore oxygen) to your body. Your heart needs to pump faster to get the blood around your body quicker. 
  • Low blood pressure. Your blood becomes thinner because you have less cells, and your heart doesn’t have time to fill completely in between beats when it’s beating faster, causing a drop in blood pressure.
  • Feeling dizzy or lightheaded.
  • Headaches.
  • Chest pain.
  • Confusion or difficulty concentrating.
  • Pale skin. This might be noticeable on the insides of your eyelids.
  • Aching muscles or joint.

Treatment and management of anaemia

Treatment of anaemia depends on the cause. If the cause of your anaemia is caused by:

  • low iron levels, you may need iron supplements such as iron tablets or an iron infusion – given by a drip into your bloodstream.
  • low vitamin B12 levels, you may need supplements such as tablets or an injection.
  • Your kidneys being unable to make enough of the hormone erythropoietin, then you may need an injection with a synthetic form of this hormone to stimulate your bone marrow to produce more red cells.

However, when your anaemia is caused by your treatment for lymphoma the management is a bit different. The cause isn’t due to a lack of something that can be replaced. It is caused by your cells being directly attacked by your treatment.

Time

You may not need any treatment for your anaemia. Your chemotherapy is given in cycles with a rest period in between each cycle, to give your body time to replace the destroyed cells.

Blood transfusion

In some cases, you may need a blood transfusion with packed red blood cells (PRBC). This is when a donor’s blood donation is filtered, and the red blood cells are removed from the rest of the blood. You then get a transfusion of their red blood cells straight into your blood stream.

A transfusion of PRBCs usually takes anywhere between 1-4 hours. However, not all hospitals have a blood bank on site, so there may be a delay as the blood comes from an exteranl site. 

For more info see
Blood Transfusions

Summary

  • Anaemia is a common side effect of treatments for lymphoma, but there are other causes as well.
  • Treatment will depend on the cause.
  • Red blood cells have a protein called haemoglobin on them, which gives them their red colour.
  • Oxygen binds to haemoglobin and is taken to all parts of our body when the blood flows through them.
  • Red blood cells also take waste products such as carbon dioxide from our body to our lungs to be breathed out.
  • Symptoms of anaemia are due to having thinner blood, and not enough oxygen getting the cells in our body.
  • When our red cell and oxygen are low, our kidneys make more of the hormone erythropoietin to stimulate our bone marrow to make more red blood cells.
  • You may need a blood transfusion to top up your red cells.
  • If you have any questions about anemia or blood transfusion you can call our Lymphoma Care Nurses Monday-Friday 9am-4:30pm Easter Standard Time. Click on the contact us button on the bottom of the screen for contact details.

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