1986 Volume 27 Issue 1 Pages 36-42
Although refractory anemias in the broad sense are not a homogenous disease entity, their spectrum of clinical and hematological features have been sufficiently characterized to permit prospective observation. Based on the clinical and hematological data of 265 patients, new diagnostic criteria for the diagnosis of refractory anemias is proposed.
The criteria for screening includes
1) anemia (including bicytopenia and pancytopenia),
2) cellular marrow,
3) chronic irreversible course,
4) absence of underlying causes or drugs and
5) marrow blasts less than 20%.
Cases of myloproliferative disorders, aplastic anemia, idiopathic thrombocytopenic purpura or hemolytic anemia be excluded. The criteria for confirmation includes presence of ineffective hemopoiesis and/or dysplastic morphological changes. Refractory anemias in the broad sence are classified into four disease types, primary acquired refractory anemia, primary acquired sideroblastic anemia, refractory anemia with excess of blasts, and refractory cytopenia. Certain morphological features of diagnostic relevance were also described to facilitate the distinction of the disease types.
