Refractory Anemia (aka Aregenerative Anemia)
General: Erythroid (unilineage) dysplasia and anemia (usually normochromic and either normocytic or macrocytic, rarely hypochromic) refractory to hematinic (iron and folic acid) therapy, with other possible etiologies excluded. These include drug/toxin, viral, immunologic, congenital, and deficiency disorders.
Rare, comprising about 5~10% of all MDS cases, and primarily affects older adults. Presenting symptoms are those of anemia.
Gross: N/A
Microscopic: There is erythroid (unilineage) dysplasia, which must be unequivocally present but may be minimal; very minimal dysplasia of other lineages is "allowed" but should be considered carefully. The number of erythroid precursors may vary, and thus marrow cellularity may vary.
- Peripheral Blood: <1% blasts, anemia, +/-variable anisopoikilocytosis.
- Bone Marrow: <5% blasts, <15% ringed sideroblasts, erythroid lineage dysplasia only.
Stains: Best utilized to assist with counts and to rule out some other process.
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