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Myelodysplasia and Iron-Transport Deficiency Anemia

by Alan E. Lichtin, MD

In myelodysplastic syndrome (see Myelodysplastic Syndrome), anemia is commonly prominent. The anemia can be microcytic or normochromic-normocytic, usually with a dimorphic (large and small) population of circulating cells. Bone marrow examination shows decreased erythroid activity, megaloblastoid and dysplastic changes, and, sometimes, increased numbers of ringed sideroblasts. Treatment is the same as for sideroblastic anemias (see Sideroblastic Anemias).

Iron-transport deficiency anemia (atransferrinemia) is exceedingly rare. It occurs when iron cannot move from storage sites (eg, mucosal cells, liver) to the erythropoietic precursors. The presumed mechanism is absence of transferrin or presence of a defective transferrin molecule. In addition to anemia, hemosiderosis of lymphoid tissue, especially along the GI tract, is prominent.

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