Red cell production failure

• Where anaemia is due solely to absence of RBC production, transfusion requirement should be ~1 unit packed red cells/week. Suitable protocol is 3 unit transfusion every 3 weeks as day case.

• If requirement is greater, investigate for bleeding and haemolysis.

• If requirement is chronic e.g. a young patient with MDS, consider giving desferrioxamine as long-term iron chelation (see p90).

• Erythropoietin may be tried where some red cell production capacity remains and transfusion needs to be avoided or minimised e.g. Jehovah's Witnesses.

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