Advances in the anemia of chronic disease

The anemia found in patients with chronic infectious, inflammatory, and neo plastic disorders, known as the anemia of chronic disease (ACD), is one of the most common syndromes in medicine. A characteristic finding of the diso rders associated with ACD is increased production of the cytokines that med iate the immune or inflammatory response, such as tumor necrosis factor, in terleukin-1, and the interferons. All the processes involved in the develop ment of ACD can be attributed to these cytokines, including shortened red c ell survival, blunted erythropoietin response to anemia, impaired erythroid colony formation in response to erythropoietin, and abnormal mobilization of reticuloendothelial iron stores. In this review advances in the understa nding of the diagnostic, pathophysiologic, and therapeutic aspects of this syndrome are summarized. (C) 1999 The Japanese Society of Hematology.