Anaemia-macrocytic

Definition

Anaemia (Haemoglobin below normal range) and macrocytosis (MCV above normal range).

This guideline is also applicable to patients with macrocytosis with additional blood abnormalities (e.g. neutropenia, thrombocytopenia, monocytosis, or combinations of abnormalities).

Myelodysplasia (MDS)

The major diagnosis to be considered in patients with macrocytic anaemia which is not caused by B12/folate deficiency, thyroid disorders, or reticulocytosis, is myelodysplasia.  This is a clonal marrow disorder causing peripheral blood cytopenias (sometimes increased monocytes).  It generally requires a bone marrow test for confirmation of diagnosis.  Treatments are available and may include blood transfusion, erythropoietin, or other therapies.  Please note there are many subtypes of myelodysplasia ranging from a very benign disorder requiring no treatment, to an extremely serious disorder very close to acute myeloid leukaemia.  Much of the literature available on the internet concentrates on the more aggressive subtypes.