Anemia is the reduction in the level of hemoglobin, red blood cells (RBCs) or hematocrit below their lower normal range. There are different types and causes of anemia. Anemia subdivides into microcytic, macrocytic and normocytic variants. Myelophthisic anemia categorizes under the normocytic variety of anemia. Normocytic anemia has the mean corpuscular volume (MCV) within the normal range of 80 to 100 fL. Other types of normocytic anemia apart from myelophthisic anemia include aplastic anemia, anemia of chronic disease and anemia of renal disease. Microcytic anemia is anemia with MCV below 80 fL, and they include sideroblastic anemia, iron deficiency anemia and thalassemia. The macrocytic anemias have MCV greater than 100 fL, and they include megaloblastic anemia and non-megaloblastic anemia. Anemia can be asymptomatic or can present with mild to severe symptoms. Severe symptoms can be devastating since it can limit the functional capacity of the individual in carrying out even basic activities of daily living. A recent article by Kassebaum NJ et al. reported that about 27% of the world population is affected by anemia with iron deficiency anemia being the most common subtype implicated. Anemia considerably affects morbidity and mortality, and thereby there is the utmost relevance in making a timely diagnosis and undertaking effective treatment of the same. Myelophthisic anemia is anemia characterized by the presence of immature erythrocytes in the peripheral blood due to the infiltration (crowding out) of the bone marrow by abnormal tissue. It is of a hypo-proliferative variant of anemia because it results from inadequate production of red blood cells from the bone marrow. Hypo-proliferative anemia is different from other forms of anemia since the reticulocyte count is usually low compared to anemia caused by increased blood loss or peripheral destruction wherein the reticulocyte count mostly increases. Other causes of hypo-proliferative anemia include nutritional deficiencies, toxin exposures, endocrine abnormalities, hematologic malignancies, and bone marrow failure syndromes.  This article will be focusing on myelophthisic anemia, and its epidemiology, etiology, pathophysiology, complications, evaluations, and management.
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