Different types of anemias


Although many parts of the body help make red blood cells, most of the work is done in the bone marrow. Bone marrow is the soft tissue in the center of bones that helps form all blood cells.

Healthy red blood cells last between 90 and 120 days. Parts of your body then remove old blood cells. A hormone called erythropoietin (epo) made in your kidneys signals your bone marrow to make more red blood cells.

Hemoglobin is the oxygen-carrying protein inside red blood cells. It gives red blood cells their color. People with anemia do not have enough hemoglobin.

The body needs certain vitamins, minerals, and nutrients to make enough red blood cells. Iron, vitamin B12, and folic acid are three of the most important ones. The body may not have enough of these nutrients due to:

  • Changes in the lining of the stomach or intestines affect how well nutrients are absorbed (for example, celiac disease)
  • Poor diet
  • Surgery that removes part of the stomach or intestines

Possible causes of anemia include:

  • Iron deficiency
  • Vitamin B12 deficiency
  • Folate deficiency
  • Certain medicines
  • Destruction of red blood cells earlier than normal (which may be caused by immune system problems)
  • Long-term (chronic) diseases such as chronic kidney disease, cancer, ulcerative colitis, or rheumatoid arthritis
  • Some forms of anemia, such as thalassemia or sickle cell anemia, which can be inherited
  • Pregnancy
  • Problems with bone marrow such as lymphoma, leukemia, myelodysplasia, multiple myeloma, or aplastic anemia
  • Slow blood loss (for example, from heavy menstrual periods or stomach ulcers)
  • Sudden heavy blood loss

Everything you need to know about anemia

The body needs red blood cells to survive. They carry hemoglobin, a complex protein that contains iron molecules. These molecules carry oxygen from the lungs to the rest of the body.
Some diseases and conditions can result in a low level of red blood cells.

There are many types of anemia, and there is no single cause. It can sometimes be difficult to pinpoint the exact cause.

Below is a general overview of the common causes of the three main groups of anemia:

1) Anemia caused by blood loss

The most common type of anemia—iron deficiency anemia—often falls into this category. It is caused by a shortage of iron, most often through blood loss.

When the body loses blood, it reacts by pulling in water from tissues outside the bloodstream in an attempt to keep the blood vessels filled. This additional water dilutes the blood. As a result, the red blood cells are diluted.

Blood loss can be acute and rapid or chronic.

Rapid blood loss can include surgery, childbirth, trauma, or a ruptured blood vessel.

Chronic blood loss is more common in cases of anemia. It can result from a stomach ulcer, cancer, or tumor.

Causes of anemia due to blood loss include:

  • gastrointestinal conditions, such as ulcers, hemorrhoids, cancer, or gastritis
  • use of non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen
  • menstrual bleeding

2) Anemia caused by decreased or faulty red blood cell production

Bone marrow is a soft, spongy tissue found in the center of bones. It is essential for the creation of red blood cells. Bone marrow produces stem cells, which develop into red blood cells, white blood cells, and platelets.

A number of diseases can affect bone marrow, including leukemia, where too many abnormal white blood cells are produced. This disrupts normal production of red blood cells.

Other anemias caused by decreased or faulty red blood cells include:

  • Sickle cell anemia: Red blood cells are misshapen and break down abnormally quickly. The crescent-shaped blood cells can also get stuck in smaller blood vessels, causing pain.
  • Iron-deficiency anemia: Too few red blood cells are produced because not enough iron is present in the body. This can be because of a poor diet, menstruation, frequent blood donation, endurance training, certain digestive conditions, such as Crohn’s disease, surgical removal of part of the gut, and some foods.
  • Bone marrow and stem cell problems: Aplastic anemia, for example, occurs when few or no stem cells are present. Thalassemia occurs when red blood cells cannot grow and mature properly.
  • Vitamin deficiency anemia: Vitamin B-12 and folate are both essential for the production of red blood cells. If either is deficient, red blood cell production will be too low. Examples include megaloblastic anemia and pernicious anemia.

3) Anemia caused by the destruction of red blood cells

Red blood cells typically have a life span of 120 days in the bloodstream, but they can be destroyed or removed beforehand.

One type of anemia that falls into this category is autoimmune hemolytic anemia, where the body’s immune system mistakenly identifies its own red blood cells as a foreign substance and attacks them.

Excessive hemolysis (red blood cell breakdown) can occur for many reasons, including:

  • infections
  • certain drugs, for example, some antibiotics
  • snake or spider venom
  • toxins produced through advanced kidney or liver disease
  • an autoimmune attack, for instance, because of hemolytic disease
  • severe hypertension
  • vascular grafts and prosthetic heart valves
  • clotting disorders
  • enlargement of the spleen


What is anemia?

Anemia happens when a person’s blood is low on hemoglobin and does not have enough red blood cells. Hemoglobin is a protein that helps carry oxygen through the body. When a person develops anemia, he or she is said to be “anemic.”

There are several different types of anemia. Each type is caused by one of these factors:

  • The body cannot make enough hemoglobin.
  • The body makes hemoglobin, but the hemoglobin doesn’t work correctly.
  • The body does not make enough red blood cells.
  • The body breaks down red blood cells too fast.

Who is most likely to develop iron-deficiency anemia?

Anyone can develop iron-deficiency anemia, although the following groups have a higher risk:

  • Women: Blood loss during monthly periods and childbirth can lead to anemia.
  • Children, ages 1 to 2: The body needs more iron during growth spurts.
  • Infants: Infants may get less iron when they are weaned from breast milk or formula to solid food. Iron from solid food is not as easily taken up by the body.
  • People over 65: People over 65 are more likely to have iron-poor diets.
  • People on blood thinners: These include aspirin, Plavix®, Coumadin®, or heparin.

If I am pregnant, should I be concerned about anemia?

Yes. If you are pregnant, you are more likely to develop iron-deficiency anemia. Your unborn baby relies on you for iron and other nutrients. Many women who are pregnant take iron pills to prevent anemia.

To make sure that you have enough iron for you and your baby, eat well-balanced meals and follow your healthcare provider’s instructions for taking vitamins and adding iron to your diet.

Are there different types of anemia?

Yes. Iron-deficiency anemia is just one type of anemia. Other types are caused by:

  • Diets lacking in vitamin B12 (the body is unable to use, or absorb Vitamin B12)
  • Diets lacking in folic acid (or, the body is unable to use folic acid)
  • Inherited blood disorders (sickle cell anemia, thalassemia)
  • Conditions that cause red blood cells to break down too fast

This chart describes some of the different types of anemia, their causes and the related blood factors:

Iron-deficiency anemia

  • Causes: Blood loss, not enough iron in the diet
  • Factors: Body cannot make enough red blood cells.

Pernicious anemia

  • Causes: Body is unable to absorb vitamin B12.
  • Factors: Body cannot make enough red blood cells.

Folic acid-deficiency anemia

  • Causes: Not enough folic acid in the diet; body is unable to use folic acid; or caused by an illness
  • Factors: Body cannot make enough red blood cells.

Hemolytic anemia

  • Causes: Inherited or acquired diseases that cause the red blood cells to be deformed; harmful substances; reaction to certain drugs
  • Factors: Body breaks down red blood cells too fast.

Sickle cell anemia

  • Causes: Inherited disease that is most common among African-Americans; red blood cells become sickle-shaped
  • Factors: Hemoglobin doesn’t work right; the shape of the red blood cells causes them to clog blood vessels and break down easily.

What causes anemia?

The most common cause of anemia is low levels of iron in the body. This type of anemia is called iron-deficiency anemia. Your body needs iron to make hemoglobin; without the needed amount of iron, your body cannot make hemoglobin.

Causes of low iron in the body:

  • Bleeding, either from losing a large amount of blood quickly (for instance, in a serious accident) or losing small amounts of blood over a long period of time. The body loses more iron with blood loss than it is able to replace with food. This can happen to women having heavy menstrual periods or in people who have inflammatory bowel disease.
  • Not enough iron in the diet
  • An increase in the body’s need for iron (during pregnancy)

What are the symptoms of anemia?

Several symptoms occur in all types of anemia, including:

  • Feeling tired
  • Shortness of breath
  • Dizziness
  • Headache
  • Feeling cold
  • Weakness
  • Pale skin

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Anemia of Inflammation or Chronic Disease

On this page:

  • What is anemia of inflammation?
  • Why is anemia of inflammation also called anemia of chronic disease?
  • Are there other types of anemia?
  • How common is anemia of inflammation?
  • Who is more likely to have anemia of inflammation?
  • Does anemia of inflammation lead to other health problems?
  • What are the symptoms of anemia of inflammation?
  • What causes anemia of inflammation?
  • Chronic conditions that cause anemia of inflammation
  • Other causes of inflammation that may lead to anemia
  • How do health care professionals diagnose anemia of inflammation?
  • How do health care professionals treat anemia of inflammation?
  • Can I prevent anemia of inflammation?
  • How does eating, diet, and nutrition affect anemia of inflammation?
  • Clinical Trials for Anemia of Inflammation
  • What are clinical trials for anemia of inflammation?
  • What clinical studies for anemia of inflammation are looking for participants?

What is anemia of inflammation?

Anemia of inflammation, also called anemia of chronic disease or ACD, is a type of anemia that affects people who have conditions that cause inflammation, such as infections, autoimmune diseases, cancer, and chronic kidney disease (CKD).

Anemia is a condition in which your blood has fewer red blood cells than normal. Your red blood cells may also have less hemoglobin than normal. Hemoglobin is the iron-rich protein that allows red blood cells to carry oxygen from your lungs to the rest of your body. Your body needs oxygen to work properly. With fewer red blood cells or less hemoglobin, your body may not get enough oxygen.

In anemia of inflammation, you may have a normal or sometimes increased amount of iron stored in your body tissues, but a low level of iron in your blood. Inflammation may prevent your body from using stored iron to make enough healthy red blood cells, leading to anemia.

Anemia is a condition in which your blood has fewer red blood cells or less hemoglobin than normal.

Why is anemia of inflammation also called anemia of chronic disease?

Anemia of inflammation is also called anemia of chronic disease because this type of anemia commonly occurs in people who have chronic conditions that may be associated with inflammation.

Are there other types of anemia?

There are many types of anemia. Common types include

  • iron-deficiency anemia, a condition in which the body’s stored iron is used up, causing the body to make fewer healthy red blood cells. In people with iron-deficiency anemia, iron levels are low in both body tissues and the blood. This is the most common type of anemia.
  • pernicious anemia, which is caused by a lack of vitamin B12.
  • aplastic anemia, a condition in which the bone marrow doesn’t make enough new red blood cells, white blood cells, and platelets because the bone marrow’s stem cells are damaged.
  • hemolytic anemia, a condition in which red blood cells are destroyed earlier than normal.

How common is anemia of inflammation?

Anemia of inflammation is the second most common type of anemia, after iron-deficiency anemia.1

Who is more likely to have anemia of inflammation?

While anemia of inflammation can affect people of any age, older adults are more likely to have this type of anemia because they are more likely to have chronic diseases that cause inflammation. In the United States, about 1 million people older than age 65 have anemia of inflammation.2

Does anemia of inflammation lead to other health problems?

Anemia of inflammation is typically mild or moderate, meaning that hemoglobin levels in your blood are lower than normal but not severely low. If your anemia becomes severe, the lack of oxygen in your blood can cause symptoms, such as feeling tired or short of breath. Severe anemia can become life-threatening.

In people who have CKD, severe anemia can increase the chance of developing heart problems.

What are the symptoms of anemia of inflammation?

Anemia of inflammation typically develops slowly and may cause few or no symptoms. In fact, you may only experience symptoms of the disease that is causing anemia and not notice additional symptoms.

Symptoms of anemia of inflammation are the same as in any type of anemia and include

  • a fast heartbeat
  • body aches
  • fainting or feeling dizzy or light-headed
  • feeling tired or weak
  • getting tired easily during or after physical activity
  • pale skin
  • shortness of breath

What causes anemia of inflammation?

Experts think that when you have an infection or disease that causes inflammation, your immune system causes changes in how your body works that may lead to anemia of inflammation.

  • Your body may not store and use iron normally.
  • Your kidneys may produce less erythropoietin (EPO), a hormone that signals your bone marrow—the spongy tissue inside most of your bones—to make red blood cells.
  • Your bone marrow may not respond normally to EPO, making fewer red blood cells than needed.
  • Your red blood cells may live for a shorter time than normal, causing them to die faster than they can be replaced.

Chronic conditions that cause anemia of inflammation

Many different chronic conditions can cause inflammation that leads to anemia, including

  • autoimmune diseases, such as rheumatoid arthritis or lupus
  • cancer
  • chronic infections, such as HIV/AIDS and tuberculosis
  • CKD
  • inflammatory bowel disease (IBD), such as Crohn’s disease or ulcerative colitis
  • other chronic diseases that involve inflammation, such as diabetes and heart failure

In people with certain chronic conditions, anemia may have more than one cause. For example

  • Causes of anemia in CKD may include inflammation, low levels of EPO due to kidney damage, or low levels of the nutrients needed to make red blood cells. Hemodialysis to treat CKD may also lead to iron-deficiency anemia.
  • People with IBD may have both iron-deficiency anemia due to blood loss and anemia of inflammation.
  • In people who have cancer, anemia may be caused by inflammation, blood loss, and cancers that affect or spread to the bone marrow. Cancer treatments such as chemotherapy and radiation therapy may also cause or worsen anemia.

Other causes of inflammation that may lead to anemia

While anemia of inflammation typically develops slowly, anemia of critical illness is a type of anemia of inflammation that develops quickly in patients who are hospitalized for severe acute infections, trauma, or other conditions that cause inflammation.

In some cases, older adults develop anemia of inflammation that is not related to an underlying infection or chronic disease. Experts think that the aging process may cause inflammation and anemia.

How do health care professionals diagnose anemia of inflammation?

Health care professionals use a medical history and blood tests to diagnose anemia of inflammation.

Medical history

A health care professional will ask about your history of infections or chronic diseases that may lead to anemia of inflammation.

Blood tests

Health care professionals use blood tests to check for signs of anemia of inflammation, other types of anemia, or other health problems. A health care professional will take a blood sample from you and send the sample to a lab to test.

Blood count tests can check many parts and features of your blood, including

  • the number of red blood cells
  • the average size of red blood cells
  • the amount of hemoglobin in your blood and in your red blood cells
  • the number of developing red blood cells, called reticulocytes, in your blood

Some of these blood count tests and others may be combined in a test called a complete blood count. A blood smear may be used to examine the size, shape, and number of red blood cells in your blood.

A health care professional may also use blood tests to check the amount of iron in your blood and stored in your body. These tests may measure

  • iron in your blood
  • transferrin, a protein in your blood that carries iron
  • ferritin, the protein that stores iron in your body’s cells

A health care professional may diagnose anemia of inflammation if blood test results suggest that you have anemia, a low level of iron in your blood, and a normal level of iron stored in your body tissues.

If blood test results suggest you have anemia of inflammation but the cause is unknown, a health care professional may perform additional tests to look for the cause.

For a blood test, a health care professional will take a blood sample from you and send the sample to a lab.

How do health care professionals treat anemia of inflammation?

Health care professionals treat anemia of inflammation by treating the underlying condition and by treating the anemia with medicines and occasionally with blood transfusions.

Treating the underlying condition

Health care professionals typically treat anemia of inflammation by treating the underlying condition that is causing inflammation. If treatments are available that can reduce the inflammation, the treatments may cause the anemia to improve or go away. For example, taking medicines to treat inflammation in rheumatoid arthritis can improve anemia.


A health care professional may prescribe the erythropoiesis-stimulating agents (ESAs) epoetin alpha or darbepoetin alpha to treat anemia related to CKD, chemotherapy treatments for cancer, or certain treatments for HIV. ESAs cause the bone marrow to make more red blood cells. Health care professionals typically give ESAs as shots and may teach you how to give yourself these shots at home. A health care professional may prescribe iron supplements, given as pills or shots, to help ESAs work.

If you’re on hemodialysis, you may be able to receive intravenous (IV) ESAs and iron supplements during hemodialysis. Read more about treatments for anemia in CKD.

Blood transfusions

In some cases, health care professionals may use blood transfusions to treat severe anemia of inflammation. A blood transfusion can quickly increase the amount of hemoglobin in your blood and boost oxygen.

Can I prevent anemia of inflammation?

Experts have not yet found a way to prevent anemia of inflammation. For some chronic conditions that cause inflammation, treatments may be available to reduce or prevent the inflammation that can lead to anemia. Talk with your doctor about treatments and follow the treatment plan your doctor recommends.

How does eating, diet, and nutrition affect anemia of inflammation?

If you have a chronic condition that is causing anemia of inflammation, follow the advice of your doctor or dietitian about healthy eating and nutrition.

Clinical Trials for Anemia of Inflammation

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions, including blood diseases.

What are clinical trials for anemia of inflammation?

Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future.

Researchers are studying many aspects of anemia of inflammation, including new treatments for this condition.

Find out if clinical studies are right for you.

What clinical studies for anemia of inflammation are looking for participants?

You can find clinical studies on anemia of inflammation at www.ClinicalTrials.gov. In addition to searching for federally funded studies, you can expand or narrow your search to include clinical studies from industry, universities, and individuals; however, the NIH does not review these studies and cannot ensure they are safe. Always talk with your health care provider before you participate in a clinical study.

Types of anemia

Anemia is a condition that many people associate with low iron levels. While this is a common cause of anemia, there are also other types of anemia that cause the same symptoms, which makes it difficult to distinguish between them.

Anemia is a common blood disorder that occurs when your level of healthy red blood cells is too low. Red blood cells contain a protein called hemoglobin, which is responsible for carrying oxygen to the tissues and gives blood its red colour. People with anemia often feel tired because there is not enough oxygen being delivered to their tissues.

There are many different types of anemia and depending on the type, symptoms of anemia can be mild to severe and the duration of symptoms can range from brief episodes to a chronic condition. Symptoms of anemia include fatigue, weakness, pale skin, shortness of breath, dizziness, chest pain, headache, and cold hands and feet.

If you have symptoms of anemia, it is very important that you see your doctor in order to determine which type of anemia you have, as some forms can be very serious and potentially life-threatening. The following is an overview on different types of anemia and their causes.

Iron deficiency anemia

Iron deficiency anemia is the most common form of anemia. It occurs when your iron levels are too low. Your body needs iron in order to make hemoglobin.

Low iron levels can be due to blood loss. Blood loss can occur due to heavy or long menstrual periods, uterine fibroids, ulcers, colon cancer, infections, severe injury, or regular use of acetylsalicylic acid (ASA). Low iron levels could also be caused by a lack of iron in the diet.

Iron-rich foods include meat, fish, poultry, eggs, dairy products, and iron-fortified foods. Alternatively, iron deficiency anemia could be caused by an inability to absorb iron due to conditions like Crohn’s disease or celiac disease.

Vitamin deficiency anemia (megaloblastic anemia)

Your body also needs vitamin B12 and folate in order to produce enough red blood cells. Anemia due to vitamin B12 deficiency is called pernicious anemia and usually occurs when the body is not able to absorb vitamin B12 properly or due to intestinal problems. This type can also be caused by a lack of vitamin B12 in the diet.

Anemia due to folate (also called folic acid) deficiency is called folate deficiency anemia and is normally due to problems with absorbing vitamins or a diet lacking in folate. These types of vitamin deficiency anemias are also known as megaloblastic anemia, which refers anemia that causes red blood cells to be larger than their normal size.

Anemia of chronic disease

There are many chronic diseases that can disrupt the body’s ability to produce red blood cells. Examples include HIV/AIDS, rheumatoid arthritis, Crohn’s disease, and kidney diseases.

Aplastic anemia

This is a rare type of anemia in which the bone marrow decreases its production of all types of blood cells (including red blood cells, white blood cells, and platelets). The cause is uncertain but it may be due to an autoimmune disorder, a viral infection, cancer treatments, or exposure to toxic chemicals. It may also be inherited.

Sickle cell anemia

This type of anemia is due to a problem with hemoglobin that causes red blood cells to have an abnormal crescent shape. The body destroys these cells quickly and new red blood cells cannot be made fast enough. Sickle cell anemia is a genetic disorder (i.e., it runs in the family).

Anemias associated with bone marrow disease

Many cancer and cancer-like disorders can cause a decrease in or even a complete shutdown of the blood-cell-making process of the bone marrow. Examples of these diseases include leukemia, myelodysplasia, and multiple myeloma.

Hemolytic anemia

This is due to red blood cells being destroyed faster than the bone marrow can produce new ones. The reason for the premature death of red blood cells may be due to the red blood cells themselves (inherited) or because of outside factors. Underlying causes include blood diseases, autoimmune disorders, and certain medications.

Other anemias

There are other rare forms of anemia, including thalassemia, G6DP deficiency, and hereditary spherocytosis.


Treatment for anemia depends on the type that you have. If it is due to lack of iron, vitamin B12, or folate in the diet, correcting the problem might be as easy as changing your diet or taking supplements.

For more severe forms of anemia, treatment may include blood transfusions, a bone marrow transplant, medications that suppress the immune system, or surgery. If you have symptoms of anemia, see your doctor as soon as possible.

Aplastic anaemia

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      • Caring for my 40-year-old son with blood cancer
      • Leukaemia: Mackenzie’s story
      • Myeloma: I am ready to enjoy each day more
      • From stuntman to stem cells
      • I’ve beaten a heart attack and CML
      • Leukaemia: It changed everything
      • Feeling the physical, emotional and financial effects
      • Lisa Christie shares her stem cell transplant experience
      • From blood cancer to Blood Buddy
      • Leukaemia: Superhero Bayley is beating the blood cancer bad guy
      • Growing stronger but taking nothing for granted
      • MPN: I wouldn’t change life for quids
      • Hakuna Matata: Will’s philosophy
      • Leukaemia: There was support to help me
      • Leukaemia: I was a 15-year-old fighting for my life
      • I wanted to let my story help others
      • Lymphoma: it’s made me value my life
      • Leukaemia: From clinical trial to remission
      • Lymphoma: I had no symptoms at all
      • Daniela is back on her feet after blood cancer
      • Leukaemia: I relapsed three times.
      • Lymphoma: “I was ready to end it all”
      • Dan Hartley: We couldn’t have got through the past year without you
      • Chloe & family say “Thank you”
      • Lymphoma: My worst and best experience
      • Lymphoma: My whole life had to be put on hold
      • Myeloma: I had a wig made for my son’s wedding
      • Deyan’s last option
      • Providing a home full of heart
      • Leukaemia: Staying positive got me through
      • Asciminib – the best treatment Lisa’s had in 16 years
      • Leukaemia: Emotionally, psychologically, mentally the hardest thing
      • GVHD: Our life is just another version of normal
      • Leukaemia: Two transfusions to make daughter’s wedding
      • Leukaemia: Four months old and fighting two different blood cancers
      • Myeloma: I thought I’d never see Dad again
      • ‘Total blinking shock’ of leukaemia
      • Myeloma at 25
      • Leukaemia: “I have two healthy sons living full lives”
      • Lymphoma: Shock at cancer covering windpipe
      • HCLv: Matt travels to the other side of the world for his ‘miracle drug’
      • Leukaemia: Josh ‘hit cancer on the head’ to get family home
      • CML: “Something wasn’t right”
      • Leukaemia: My blood cancer came back
      • HLH: Kai’s courageous battle with rare disorder
      • Robert’s battler spirit not only helped him take on the Kokoda trail but also an ALL diagnosis
      • Leukaemia: “Everyone is their own person”
      • Childhood leukaemia: Lizzie’s still laughing despite battle
      • Leukaemia: The doctor rang me and said, “I’m sorry”
      • Leukaemia: My world was turned upside down
      • Waldenstrom’s: I’ve learned as much as possible about my illness
      • Leukaemia: I felt like I was having a bad dream
      • Leukaemia: She was only six hours old
      • Lymphoma: I am now a happier, more fulfilled person
      • Leukaemia: Our world came to a grinding halt
      • Leukaemia: I am a survivor
      • Lymphoma: Challenges bring moments for growth and learning
      • Amyloidosis: I wondered whether I would die
    • #5words2bloodcancer
    • Disease newsletters
    • World Lymphoma Awareness Day
    • Videos
    • Booklets and fact sheets
    • Facts and statistics about blood cancer
    • Resources for healthcare professionals
    • Useful websites
    • Glossary of terms
  • Other therapies
  • Refractory Cancer
  • Supportive care
    • Iron overload and iron chelation therapy
  • Drug Availability in Australia
  • Frequently asked questions

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