Sideroblastic anemia natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nazia Fuad M.D.

Overview

Majority of patients of sideroblastic anemia at the time of diagnosis shows erythroid abnormalities and ineffective erythropoiesis,
Granulocytic and megakaryocytic cell lines involvement is also common.
In the initial stages bone marrow reveal erythroid expansion with ineffective erythropoiesis
Progression to bone marrow failure occurs in the course of the disease
The next phase in natural history of sideroblastic anemia is iron overload and evolution to nonlymphocytic leukemia
The most common causes of death are related to complications of iron overload and evolution into ANLL..^[1]

Common complications of sideroblastic anemia include

Depending on the type of sideroblastic anemia the prognosis may vary. However, the prognosis is generally regarded as good^[1].
Sideroblastic anemia secondry to drugs or alcohol as underlying cause is associated with the most favorable prognosis.
(5-10%) of Severe refractory sideroblastic anemias associated with MDS undergo leukemic transformation.
AML markedly reduce life expectancy
Patients who do not need blood transfusions are likely to be long-term survivors.
The transfusion dependent are at risk of death from the complications of secondary hemochromatosis.

↑ ^1.0 ^1.1 Cazzola M, Barosi G, Gobbi PG, Invernizzi R, Riccardi A, Ascari E (February 1988). "Natural history of idiopathic refractory sideroblastic anemia". Blood. 71 (2): 305–12. PMID 3337899.