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What is Refractory Anemia?

Tricia Christensen
Updated Mar 03, 2024
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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 symptoms can include an enlarged spleen, difficulty drawing breath, and trouble staying active for any lengthy period due to exhaustion.

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 jump start 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 worst 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 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 elderly males, who are most likely to develop refractory anemia. There are a number of clinical trials in which older patients might take part, however. People with this diagnosis should weigh options carefully and get advice from specialists on the most promising trials.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Tricia Christensen
By Tricia Christensen
With a Literature degree from Sonoma State University and years of experience as a The Health Board contributor, Tricia Christensen is based in Northern California and brings a wealth of knowledge and passion to her writing. Her wide-ranging interests include reading, writing, medicine, art, film, history, politics, ethics, and religion, all of which she incorporates into her informative articles. Tricia is currently working on her first novel.
Discussion Comments
By SimpleByte — On Feb 14, 2014

@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.

By Nefertini — On Feb 13, 2014

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

By Ceptorbi — On Feb 13, 2014

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.

Tricia Christensen
Tricia Christensen
With a Literature degree from Sonoma State University and years of experience as a The Health Board contributor, Tricia...
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