Summary.Five cases of sideroblastic anaemia associated with malignant diseases of the bone marrow are reported. The first patient had a 20‐yr history of ‘refractory anaemia’ and developed acute myeloid leukaemia as a terminal event, the second had chronic monocytic leukaemia for 6 yr, and the third suffered from myeloblastic leukaemia. The two remaining patients presented with severe refractory hypochromic anaemia, and myelomatosis was an unexpected finding on examination of the bone marrow. The histories of these five patients and those of similar patients reported in the literature suggest that sideroblastic anaemia can develop as the consequence of bone‐marrow stem cell mutations, which can lead to several types of cellular dysfunction. In some patients sideroblastic anaemia may be the only demonstrable change; in others, subsequent mutations may lead to overt leukaemia, while in still others sideroblast formation may be a minor phenomenon over‐shadowed from the start by an associated malignant
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