Myelodysplastic patients with raised percentage of hypochromic red cells have evidence of functional iron deficiency.
Raised percentage hypochromic red cells (%HRC) were detected at diagnosis in 10 of 34 consecutive patients with low-risk myelodysplastic syndrome (MDS) [refractory anemia (RA) (4/26) and RA with ring sideroblasts (6/8)], all of whom had normal or increased serum ferritin and bone marrow iron stores. Elevated %HRC has persisted in all 10 cases and subsequently developed in another RA patient who later had a complete remission of MDS with normalisation of %HRC after a respiratory tract infection. A strong positive correlation was found between %HRC and erythrocyte zinc protoporphyrin levels in 11 MDS patients tested (p=0.01), suggesting that functional iron deficiency contributes to ineffective erythropoiesis in cases of MDS with raised %HRC. Five of seven patients with elevated %HRC had satisfactory haemoglobin responses to a trial of human recombinant erythropoietin without iron supplementation.
Department of Haematology, Beaumont Hospital, Dublin 9, Ireland. philipmurphy@beaumont.ie
P T
PT
Murphy
J P
JP
Quinn
D
D
O'Donghaile
R
R
Swords
J R
JR
O'Donnell
D000747:Anemia, Hypochromic / Q000453:epidemiology*; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000453:epidemiology*; D001772:Blood Cell Count; D002097:C-Reactive Protein / Q000032:analysis; D005293:Ferritins / Q000097:blood; D006801:Humans; D007501:Iron / Q000097:blood; D007770:L-Lactate Dehydrogenase / Q000097:blood; D009190:Myelodysplastic Syndromes / Q000097:blood*; D015995:Prevalence; D014168:Transferrin / Q000378:metabolism
D014168:Transferrin; D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron; D007770:L-Lactate Dehydrogenase