PURPOSE OF REVIEW: Anaemia is a common haematological presentation in patients 
with bone marrow failure, yet a challenging condition to treat. As anaemia has a 
direct impact on the patient's symptoms, managing anaemia in the common bone 
marrow failure conditions, such as myelodysplastic syndrome will help to improve 
the quality of life. This review discusses the available treatment options and 
the benefit of improving the haemoglobin level.
RECENT FINDINGS: Managing anaemia effectively has shown to improve the patient 
outcome, yet treatment option remain limited. Recently, activin inhibitors such 
as Luspatercept have shown to be effective in patients' refractory to ESAs and 
further clinical trials are ongoing to explore this further.
SUMMARY: Transfusion still remains the mainstay of treatment in patients not 
suitable, lost response or refractory to erythropoiesis-stimulating agents 
(ESAs). Majority of these patients are not suitable for definite treatment 
options such as bone marrow transplantation. The aim of treatment remains 
improving the quality of life and newer therapeutic options may offer better and 
more sustained response.