Treatment with both erythrocyte stimulating agents and granulocyte colony-stimulating factor (G-CSF) may increase the erythroid response rate to nearly 40% in refractory anemia with ringed sideroblasts. However, in all forms of MDS, treatment with growth factors (ESA + G-CSF) does not improve survival and/or reduce risk of transformation to AML.

X-linked sideroblastic anemia is an inherited disorder that prevents developing red blood cells (erythroblasts) from making enough hemoglobin. This disorder also leads to an abnormal accumulation of iron in red blood cells.