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What Is Refractory Anemia?

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  • Written By: Tricia Ellis-Christensen
  • Edited By: O. Wallace
  • Last Modified Date: 22 March 2014
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Refractory anemia is four types of anemia that are all called examples of myelodysplastic syndrome (MDS). These are a group of very serious illnesses where the body doesn’t produce the appropriate amount of red blood cells, and may have immature cells of other types that aren’t ever reaching maturity. Such illnesses tend to resist treatment and have poor prognoses, though this can vary among individual patients and with new treatments that have been attempted.

The causes of MDS aren’t always identifiable. It can occur as a result of someone having radiation or chemotherapy in the recent past, which is called a secondary version of the condition. Exposure to certain chemicals has been linked to refractory anemia too, and the condition may arise without any risk factors like cancer treatment, in which case it is called a primary or de novo form. Those at greater risk are usually Caucasian males who are 60 years old or older.

The failure to adequately produce red blood cells by the bone marrow causes a number of symptoms. These include extreme fatigue, red spots on the skin called petechiae, and tendency to get ill easily. Other refractory anemia symptoms can include an enlarged spleen, difficulty drawing breath, and trouble staying active for any lengthy period due to exhaustion.

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With most types of anemia, treatment is to give supplements like iron, which can help increase blood cell production. This treatment is usually ineffective when the condition is refractory anemia. Iron supplements don’t jumpstart bone marrow production of red cells. The only choice to serve immediate body needs is to give blood transfusions to supply the body with the red blood cells that it needs.

Yet in a number of cases, such treatment is inadequate over time, and survival rate begins to decline. In worse case scenarios, as with refractory anemia with excess blasts in transformation, also called acute myeloid leukemia, the bone marrow is failing to make enough of any mature white, red or platelet cells, and the body becomes increasingly sick. This is unfortunately, cancer, but the term applies to all refractory anemia types, and there aren’t that many treatments that promise a full cure.

The cure for this condition, when it works, is with stem cells and chemotherapy, and this treatment is typically only offered to people who are relatively young. It doesn’t tend to be offered to those who are most likely to develop refractory anemia: older males. There are a number of clinical trials in which older patients might take part. People with this diagnosis should weigh options carefully and get advice from specialists on the most promising trials.

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Discuss this Article

SimpleByte
Post 3

@Nefertini, doctors perform physical exams and administer blood tests to determine whether or not a patient has anemia. My doctor once tested me for anemia because I looked pale to him, and paleness can be a sign of anemia. A complete blood count or CBC is a blood test that measures your blood's hemoglobin, the number of red and white blood cells and platelets in your blood, and the size of your red blood cells. If your CBC results are abnormal and indicate anemia, your doctor may order additional blood tests to determine the type of anemia you have.

Nefertini
Post 2

Some of these anemias sound quite severe. How do doctors arrive at an anemia diagnosis?

Ceptorbi
Post 1

Refractory anemia with ringed sideroblasts is one of the multiple refractory anemias. In it, abnormal erythroblasts called sideroblasts form which contain rings of iron granules in their mitochondria. Although the blood contains iron, the body can't utilize the iron properly to transport oxygen to the cells via hemoglobin. Treatment may include Vitamin B6, iron chelating drugs, phlebotomy, and blood transfusions.

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