H/o of all -bmt.ca breast in 2012. had chemo and letrazole . now have anaemia (hb 102g/l). ferritin581, other haematinics ok. any ideas re aetiology ?

Anemia causes: Since you had a history of leukemia and now you have anemia the best approach is to go back to the physician who treated your leukemia to rule out leukemic relapse once you rule out relapse the chemotherapy given to you for your breast cancer causes anemia but usually corrects in a three months out of chemotherapy. Do not use hematinics before treating the cause since you will accelerate leukemia.

Need more info: Would be best to discuss with your oncologist, as your full record and medications used would be available to your doctor. Good luck.

Many possibilities: You're either not producing red blood cells, losing them through bleeding, or breaking them apart (hemolysis). Since your ferritin is okay, you're probably not bleeding. You could have anemia of chronic disease, myelodysplasia, vitamin B12 or folate (folic acid) deficiency, a large spleen trapping your blood cells, or infiltration of your marrow by tumor cells. A bone marrow biopsy can help determine the cause.