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30th May 2023
A 75-year-old female is referred to the acute medical unit by her GP with symptomatic anaemia
A 75-year-old female is referred to the acute medical unit by her GP with symptomatic anaemia. She has a history of CLL and is on ‘watch and wait’ management only.
Investigations reveal the following:
| Hb | 70 g/L | (120-170 g/L) |
| WCC | 12 x 10⁹/L | (3.6-11 x 10⁹/L) |
| Platelets | 310 x 10⁹/L | (150-400 x 10⁹/L) |
| Neutrophils | 4.3 x 10⁹/L | (1.8-7.5 x 10⁹/L) |
| Lymphocytes | 7.0 x 10⁹/L | (1.0-4.0 x 10⁹/L) |
| Reticulocytes | 6% | (0.5-1.5%) |
| Bilirubin | 62 µmol/L | (<21 µmol/L) |
| LDH | 600 U/L | (140-280 U/L) |
| DAT | IgG autoantibody +++ |
Which treatment option is most suitable?
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