Red cells contain hemoglobin, the molecules that carry oxygen and carbon dioxide in the blood. Measuring hemoglobin gives an exact picture of the ability of the blood to carry oxygen. Children may have low hemoglobin levels at diagnosis and during the intensive parts of treatment. This is because both cancer and chemotherapy decrease the bone marrows ability to produce new red cells. During maintenance, your childs hemoglobin level will be higher than during induction and consolidation, but still lower than that of a healthy child. Signs and symptoms of anemia—pallor, shortness of breath, fatigue—may start to show if the hemoglobin gets very low.
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