Anemia in the Elderly

Outpatient elderly men and women (aged 65 years or older) with anemia.

Inclusion Criteria:ELDERLY ANEMIC:

1. Age 65 or older
2. Hemoglobin < 13 g/dL (in men) and < 12 g/dL (in women) on at least 2 occasions, 30 days apart, with the most recent value within at least 14 days of enrollment into the study. In addition, if a CBC is drawn on the date of enrollment, hemoglobin must meet eligibility criteria in order for the patient to enroll.
3. Outpatient at either the VAPAHCS or SHC
4. Independent/community living
5. Ability to understand and the willingness to sign a written informed consent document
6. Performance level ECOG 2 or better.

NON-ANEMIC ELDERLY CONTROL POPULATION FOR BLOOD AND URINE SAMPLES WITH OR WITHOUT BONE MARROW BIOPSY:

1. Age 65 or older
2. Hemoglobin ¡Ý 13.0 g/dL (in men) or ¡Ý 12.0 g/dL (in women) within at least 90 days of enrollment into the study
3. Normal white blood cell and platelet counts
4. Independent/ community living
5. Ability to understand and the willingness to sign a written informed consent document
6. Performance level ECOG 2 or better
7. Matched to UA population by gender and 10 year age strata (65 to < 75, 75 to < 85, 85 or older).

NON-ANEMIC YOUNG CONTROL POPULATION FOR BLOOD AND URINE SAMPLES WITH BONE MARROW BIOPSY:

1. Age 20-35
2. Hemoglobin ¡Ý 13.0 g/dL (in men) or ¡Ý 12.0 g/dL (in women) within at least 90 days of enrollment into the study
3. Normal white blood cell and platelet counts
4. Independent/ community living
5. Written informed consent obtained
6. Performance level ECOG 2 or better

NON-ANEMIC YOUNG CONTROL POPULATION FOR BLOOD AND URINE SAMPLES ONLY:

1. Age 20-64
2. Hemoglobin ¡Ý 13.0 g/dL (in men) or ¡Ý 12.0 g/dL (in women) within at least 90 days of enrollment into the study
3. Normal white blood cell and platelet counts
4. Independent/community living
5. Written informed consent obtained
6. Performance level ECOG 2 or better
7. Will be recruited by the following age strata: 20 to < 35, 35 to < 50, 50 to < 65.

NON-ANEMIC YOUNG CONTROL POPULATION FOR BONE MARROW ONLY (these samples will be purchased from an outside vendor):

1. Age 20-35
2. Hemoglobin >= 13 g/dL in men, >= 12 g/dL in women as obtained by procurement company.

Exclusion Criteria:Exclusion criteria for all groups

1. Substance abuse or mental health or other problems that would make compliance with the protocol unlikely
2. Predicted mortality based on co-morbidities of less than 3 months
3. Known diagnosis of bone marrow disorder such as leukemia, metastatic malignancy with bone marrow involvement, myelodysplastic syndrome. Monoclonal gammopathy of undetermined significance (MGUS) will be excluded as well due to difficulty in diagnosing MGUS in the presence of anemia which fulfills criteria for end-organ damage for multiple myeloma.
4. On any erythropoiesis-stimulating agent in the prior 3 months
5. Having received any red blood cell transfusion in the prior 3 months
6. End stage renal disease as defined by the need for ongoing hemo or peritoneal dialysis
7. Endstage liver disease as defined by the patient¡-s providers in the medical record
8. A medical condition which would make participation risky
9. On any other study requiring ongoing blood or marrow donation which would make additional blood or marrow collection risky to the subject

Additional exclusion criteria for healthy controls:

1. History of active malignancy (except non-melanoma skin cancer), or radiation or chemotherapy for treatment of malignancy within the past 24 months
2. HIV positivity
3. Hepatitis B or Hepatitis C positivity
4. Autoimmune disease (including lupus, RA, IBD)
5. Known hematologic disorder