Which laboratory tests are essential for managing chemotherapy-induced myelosuppression?

• A. Complete blood count with differential (ANC and platelets) and reticulocyte count.
• B. Basic metabolic panel (BMP) only.
• C. Liver function tests (AST/ALT) only.
• D. Serum uric acid level only.

Answer: (A)

Chemo-induced myelosuppression mainly affects the bone marrow’s production of white cells, platelets, and red cells, so the essential monitoring focuses on how these lineages are doing. A complete blood count with differential provides the numbers for white blood cells, especially the absolute neutrophil count, and platelets, which are the key indicators of infection risk and bleeding risk during chemotherapy. The reticulocyte count adds information about rapidly producing red blood cells and helps determine whether anemia is due to underproduction from marrow suppression or another cause, as well as how the marrow is recovering after treatment.

Other tests like a basic metabolic panel, liver function tests, or serum uric acid aren’t central to managing myelosuppression itself. They may be important for other aspects of chemotherapy safety or complications, but they don’t directly measure or guide the marrow suppression you’re monitoring here.