Ferrokinetic Abnormalities and their Significance in Patients with Sideroblastic Anaemia

Summary. A study of 10 patients with primary acquired sideroblastic anaemia demonstrates a link between the ferrokinetic abnormalities, the clinical severity and the distribution of storage iron between the labile and the fixed stores. There appears to be a progressive change from an initial mild impairment of haemoglobin synthesis, through a phase of ineffective erythropoeisis and partial erythropoietic failure, to a final stage of complete erythropoietic failure. This progress is associated initially with an increased iron content of the labile store but in the later stages with transfer of iron to the fixed, non‐chelatable store. The change from the early Type I phase to the late Type III phase is associated with clinical deterioration and increasing transfusion requirements which are predominantly responsible for an increased iron load which is a feature of this stage of the disease.