,RECOMMENDATIONS:  ,At this time, my recommendation for the patient is that he undergoes further serologic evaluation with reticulocyte count, serum protein, and electrophoresis, LDH, B12, folate, erythropoietin level, and he should undergo a bone marrow aspiration and biopsy. 
,RECOMMENDATIONS : , At this time , my recommendation for the patient is that he undergoes further serologic evaluation with reticulocyte count , serum protein , and electrophoresis , LDH , B12 , folate , erythropoietin level , and he should undergo a bone marrow aspiration and biopsy .