Journal of Blood & Lymph

Three Cases of Refractory Anemia with Ringed Sideroblasts Who Responded to Chloroquine

Abstract

Mohammed Salhab, Ali Zaidi, Iffat Adeel, Sana Saeed , Zeba Aziz, Azra Raza and Michael Auerbach

We report three cases of myelodysplastic syndrome (MDS), refractory anemia with ringed sideroblasts (RARS), who responded to the anti-malarial chloroquine in combination with recombinant erythropoietin (darbepoetin alfa). All three patients either remained or achieved transfusion independence and increased their hemoglobin level by at least 1 gm/dl. Responses occurred rapidly, becoming clinically noticeable within the first 4-6 weeks from start of therapy. All patients were followed for at least a 6 months period during which they have remained transfusion independent. Chloroquine affects multiple cellular pathways, but the precise mechanism of its action in RARS
patients is unclear.