Monitoring
Increased haemoglobin level and reticulocytosis within 7-10 days of starting treatment suggests a positive response.[30] It is important to determine completeness of response after 8 weeks of therapy, when blood counts should have normalised.[57]
Mean corpuscular volume (MCV) may increase during the first few days of treatment, presumably because of reticulocytosis.[72] As normocytic red blood cells replace macrocytes, MCV decreases to normal range, usually within about 8 weeks of beginning treatment.[53] Neutrophil hypersegmentation may persist during the first 2 weeks of therapy, but platelet and white blood cell count rise in the first week of therapy.
Inadequate response indicates a co-existing cause of anaemia, such as iron deficiency or vitamin B12 (cobalamin) deficiency.
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