Refractory anemia (RA) is an hematologic disorder at risk of developing into a malignancy (hemopoietic dysplasia). Information on hemopoietic dysplasias is useful for sharpening the appropriate diagnostic criteria and for the search of an appropriate therapy. Moreover, hemopoietic dysplasias provide an interesting opportunity, in humans, for studying a developing leukemia, or a disease situated at the boundary of leukemia. This paper reports on the evolution of RA in 13 patients followed up more than 2 years, through clinical observation, blood and marrow examination, and karyotype analysis. 4 of these 13 patients developed acute or subacute myeloid leukemia. An additional patient died because of severe thrombocytopenia. In’ these 5 patients, dyserythropoiesis was accompanied by thrombocytopenia, marrow myeloblastosis, and nonrandom chromosome abnormalities.

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