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Refractory anemia with excess blasts is present when immature white blood cells are found in the bone marrow in abnormally large numbers (five to 20 percent bone marrow blasts, compared to normal blasts of less than one percent). Refractory anemia and refractory anemia with ringed sideroblasts primarily affect the red blood cells and are the most common forms of MDS. The disease categories on the lower end of this list are more serious and have a worse prognosis than those at the top. Refractory anemia in transformation to acute leukemia.Refractory anemia with ringed sideroblasts.Patients may experience bleeding of the gums when brushing their teeth, blood in the urine or stool, severe headache or visual changes or a stiff neck. Signs of inadequate platelets include bleeding or bruising too easily. Symptoms of infection caused by low white blood counts may include temperature rising to 38.0 C or 100.4 F, coughing, stiff neck, pain or burning with urination, sore throat, mouth or lip sores and sores that do not heal. Symptoms are paleness, feeling tired, fast-beating or pounding heart, dizziness, shortness of breath or headaches. Often it is accidentally discovered during a routine physical exam or blood test. Low red blood counts or malfunctioning red blood cells can cause anemia. Symptoms of infection caused by low white blood counts may include. Red blood cells carry oxygen to the tissues (muscles, bones, nerves and organs).Bone marrow (the spongy middle part of the large bones) produces the three main types of blood cells. An MPV blood test measures the size of your platelets, which are blood cells that help with clotting. Blood carries oxygen, chemicals and hormones to the cells in the body and helps remove toxins and waste. Myelodysplastic syndromes affect blood cell production and behavior.