The Clinical and Pathophysiological Features of Malarial Anaemia

  • D. J. Roberts
  • C. Casals-Pascual
  • D. J. Weatherall
Part of the Current Topics in Microbiology and Immunology book series (CT MICROBIOLOGY, volume 295)


This review will focus on the principal clinical and pathophysiological features of the anaemia of falciparum malaria, including the problems of treating malarial anaemia, and also will suggest how recent advances in genomics may help our understanding of cellular and molecular mechanisms underlying this syndrome.


Falciparum Malaria Malaria Infection Severe Malaria Severe Anaemia Cerebral Malaria 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Abdalla S, Weatherall DJ, Wickramasinghe SN, Hughes M (1980) The anaemia of P. falciparum malaria. Br J Haematol 46:171–183PubMedGoogle Scholar
  2. Abdalla SH (1988) Peripheral blood and bone marrow leucocytes in Gambian children with malaria: numerical changes and evaluation of phagocytosis. Ann Trop Paediatr 8:250–258PubMedGoogle Scholar
  3. Abdalla SH, Kasili FG, Weatherall DJ (1983) The coombs direct antiglobulin test in Kenyans. Trans R Soc Trop Med Hyg 77:99–102PubMedCrossRefGoogle Scholar
  4. Abdalla SH, Wickramasinghe SN (1988) A study of erythroid progenitor cells in the bone marrow of Gambian children with falciparum malaria. Clin Lab Haematol 10:33–40PubMedGoogle Scholar
  5. Abdalla SH, Wickramasinghe SN, Weatherall DJ (1984) The deoxyuridine suppression test in severe anaemia following Plasmodium falciparum malaria. Trans R Soc Trop Med Hyg 78:60–63PubMedCrossRefGoogle Scholar
  6. Ahvazi BC, Jacobs P, Stevenson MM (1995) Role of macrophage-derived nitric oxide in suppression of lymphocyte proliferation during blood-stage malaria. J Leukoc Biol 58:23–31PubMedGoogle Scholar
  7. Allred DR (1995) Immune evasion by Babesia bovis and Plasmodium falciparum: cliff-dwellers of the parasite world. Parasitol Today 11:100–105PubMedCrossRefGoogle Scholar
  8. Amodu OK, Adeyemo AA, Olumese PE, Gbadegesin RA (1998) Intraleucocytic malaria pigment and clinical severity of malaria in children. Trans R Soc Trop Med Hyg 92:54–56PubMedCrossRefGoogle Scholar
  9. Angus BJ, Chotivanich K, Udomsangpetch R, White NJ (1997) In vivo removal of malaria parasites from red blood cells without their destruction in acute falciparum malaria. Blood 90:2037–2040PubMedGoogle Scholar
  10. Beeson JG, Rogerson SJ, Cooke BM, Reeder JC, Chai W, Lawson AM, et al. (2000) Adhesion of Plasmodium falciparum-infected erythrocytes to hyaluronic acid in placental malaria. Nat Med 6:86–90PubMedCrossRefGoogle Scholar
  11. Berkley J, Mwarumba S, Bramham K, Lowe B, Marsh K (1999) Bacteraemia complicating severe malaria in children. Trans R Soc Trop Med Hyg 93:283–286PubMedCrossRefGoogle Scholar
  12. Brewster DR, Greenwood BM (1993) Seasonal variation of paediatric diseases in The Gambia, west Africa. Ann Trop Paediatr 13:133–14PubMedGoogle Scholar
  13. Brown KE (2000) Haematological consequences of parvovirus B19 infection. Baillieres Best Pract Res Clin Haematol 13:245–259PubMedGoogle Scholar
  14. Burgmann H, Looareesuwan S, Kapiotis S, Viravan C, Vanijanonta S, Hollenstein U, et al. (1996) Serum levels of erythropoietin in acute Plasmodium falciparum malaria. Am J Trop Med Hyg 54:280–283PubMedGoogle Scholar
  15. Chang KH, Tam M, Stevenson MM (2004) Inappropriately low reticulocytosis in severe malarial anemia correlates with suppression in the development of late erythroid precursors. BloodGoogle Scholar
  16. Chang KH, Tam M, Stevenson MM (2004) Modulation of the course and outcome of blood-stage malaria by erythropoietin-induced reticulocytosis. J Infect Dis 189:735–743PubMedGoogle Scholar
  17. Dicko A, Klion AD, Thera MA, Sagara I, Yalcouye D, Niambele MB, et al. (2004) The etiology of severe anemia in a village and a periurban area in Mali. Blood 104:1198–1200PubMedCrossRefGoogle Scholar
  18. Dondorp AM, Angus BJ, Chotivanich K, Silamut K, Ruangveerayuth R, Hardeman MR, et al. (1999) Red blood cell deformability as a predictor of anemia in severe falciparum malaria. Am J Trop Med Hyg 60:733–737PubMedGoogle Scholar
  19. Dormer P, Dietrich M, Kern P, Horstmann RD (1983). Ineffective erythropoiesis in acute human P. falciparum malaria. Blut 46:279–288PubMedGoogle Scholar
  20. Egan AF, Fabucci ME, Saul A, Kaslow DC, Miller LH (2002) Aotus New World monkeys: model for studying malaria-induced anemia. Blood 99:3863–3866PubMedCrossRefGoogle Scholar
  21. el Hassan AM, Saeed AM, Fandrey J, Jelkmann W (1997) Decreased erythropoietin response in Plasmodium falciparum malaria-associated anaemia. Eur J Haematol 59:299–304PubMedGoogle Scholar
  22. English M, Muambi B, Mithwani S, Marsh K (1997) Lactic acidosis and oxygen debt in African children with severe anaemia. QJM 90:563–569PubMedGoogle Scholar
  23. English M, Waruiru C, Marsh K (1996) Transfusion for respiratory distress in life-threatening childhood malaria. Am J Trop Med Hyg 55:525–530PubMedGoogle Scholar
  24. Facer CA (1980) Direct Coombs antiglobulin reactions in Gambian children with Plasmodium falciparum malaria. II. Specificity of erythrocyte-bound IgG. Clin Exp Immunol 39:279–288PubMedGoogle Scholar
  25. Facer CA, Bray RS, Brown J (1979) Direct Coombs antiglobulin reactions in Gambian children with Plasmodium falciparum malaria. I. Incidence and class specificity. Clin Exp Immunol 35:119–127PubMedGoogle Scholar
  26. Finch CA (1982) Erythropoiesis, erythropoietin, and iron. Blood 60:1241–1246PubMedGoogle Scholar
  27. Fiori PL, Rappelli P, Mirkarimi SN, Ginsburg H, Cappuccinelli P, Turrini F (1993) Reduced microbicidal and anti-tumour activities of human monocytes after ingestion of Plasmodium falciparum-infected red blood cells. Parasite Immunol 15:647–655PubMedGoogle Scholar
  28. Fleming AF (1997) HIV and blood transfusion in sub-Saharan Africa. Transfus Sci 18:167–179PubMedCrossRefGoogle Scholar
  29. Fried M, Duffy PE (1996) Adherence of Plasmodium falciparum to chondroitin sulfate A in the human placenta. Science 272:1502–1504PubMedGoogle Scholar
  30. Giribaldi G, Ulliers D, Schwarzer E, Roberts I, Piacibello W, Arese P (2004) Hemozoin-and 4-hydroxynonenal-mediated inhibition of erythropoiesis. Possible role in malarial dyserythropoiesis and anemia. Haematologica 89:492–493PubMedGoogle Scholar
  31. Groux H, Gysin J (1990) Opsonization as an effector mechanism in human protection against asexual blood stages of Plasmodium falciparum: functional role of IgG subclasses. Res Immunol 141:529–542PubMedGoogle Scholar
  32. Guyatt HL, Snow RW (2001) Malaria in pregnancy as an indirect cause of infant mortality in sub-Saharan Africa. Trans R Soc Trop Med Hyg 95:569–576PubMedCrossRefGoogle Scholar
  33. Hetzel C, Anderson RM (1996) The within host cellular dynamics of blood-stage malaria. Parasitology 113:25–28PubMedCrossRefGoogle Scholar
  34. Holst FG, Hemmer CJ, Foth C, Seitz R, Egbring R, Dietrich M (1999) Low levels of fibrin-stabilizing factor (factor XIII) in human Plasmodium falciparum malaria: correlation with clinical severity. Am J Trop Med Hyg 60:99–104PubMedGoogle Scholar
  35. Kelton JG, Keystone J, Moore J, Denomme G, Tozman E, Glynn M, et al. (1983) Immune-mediated thrombocytopenia of malaria. J Clin Invest 71:832–836PubMedCrossRefGoogle Scholar
  36. Krishna S, Waller DW, ter Kuile F, Kwiatkowski D, Crawley J, Craddock CF, et al. (1994) Lactic acidosis and hypoglycaemia in children with severe malaria: pathophysiological and prognostic significance. Trans R Soc Trop Med Hyg 88:67–73PubMedCrossRefGoogle Scholar
  37. Kurtzhals JA, Adabayeri V, Goka BQ, Akanmori BD, Oliver-Commey JO, Nkrumah FK, et al. (1998) Low plasma concentrations of interleukin 10 in severe malarial anaemia compared with cerebral and uncomplicated malaria. Lancet 351:1768–1772PubMedCrossRefGoogle Scholar
  38. Kurtzhals JA, Rodrigues O, Addae M, Commey JO, Nkrumah FK, Hviid L (1997) Reversible suppression of bone marrow response to erythropoietinin Plasmodium falciparum malaria. Br J Haematol 97:169–174PubMedCrossRefGoogle Scholar
  39. Kwiatkowski D, Cannon JG, Manogue KR, Cerami A, Dinarello CA, Greenwood BM (1989) Tumour necrosis factor production in falciparum malaria and its association with schizont rupture. Clin Exp Immunol 77:361–366PubMedGoogle Scholar
  40. Kwiatkowski D, Hill AV, Sambou I, Twumasi P, Castracane J, Manogue JR, et al. (1990) TNF concentration in fatal cerebral, non-fatal cerebral, and uncomplicated Plasmodium falciparum malaria. Lancet 336:1201–1204PubMedCrossRefGoogle Scholar
  41. Ladhani S, Lowe B, Cole AO, Kowuondo K, Newton CR (2002) Changes in white blood cells and platelets in children with falciparum malaria: relationship to disease outcome. Br J Haematol 119:839–847PubMedCrossRefGoogle Scholar
  42. Lee SH, Crocker P, Gordon S (1986) Macrophage plasma membrane and secretory properties in murine malaria. Effects of Plasmodium yoelii blood-stage infection on macrophages in liver, spleen, and blood. J Exp Med 163:54–74PubMedCrossRefGoogle Scholar
  43. Lee SH, Looareesuwan S, Wattanagoon Y, Ho M, Wuthiekanun V, Vilaiwanna N, et al. (1989) Antibody-dependent red cell removal during P. falciparum malaria: the clearance of red cells sensitized with an IgG anti-D. Br J Haematol 73:396–402PubMedGoogle Scholar
  44. Looareesuwan S, Suntharasamai P, Webster HK, Ho M (1993) Malaria in splenectomized patients: report of four cases and review. Clin Infect Dis 16:361–366PubMedGoogle Scholar
  45. Looareesuwan S, Ho M, Wattanagoon Y, White NJ, Warrell DA, Bunnag D, et al. (1987) Dynamic alteration in splenic function during acute falciparum malaria. N Engl J Med 317:675–679PubMedCrossRefGoogle Scholar
  46. Lou J, Lucas R, Grau GE (2001) Pathogenesis of cerebral malaria: recent experimental data and possible applications for humans. Clin Microbiol Rev 14:810–820PubMedCrossRefGoogle Scholar
  47. Luty AJ, Perkins DJ, Lell B, Schmidt-Ott R, Lehman LG, Luckner D, et al. (2000) Low interleukin-12 activity in severe Plasmodium falciparum malaria. Infect Immun 68:3909–3915PubMedCrossRefGoogle Scholar
  48. MacPherson GG, Warrell MJ, White NJ, Looareesuwan S, Warrell DA (1985) Human cerebral malaria. A quantitative ultrastructural analysis of parasitized erythrocyte sequestration. Am J Pathol 119:385–401PubMedGoogle Scholar
  49. Maggio-Price L, Brookoff D, Weiss L (1985) Changes in hematopoietic stem cells in bone marrow of mice with Plasmodium berghei malaria. Blood 66:1080–1085PubMedGoogle Scholar
  50. Marsh K, Forster D, Waruiru C, Mwangi I, Winstanley M, Marsh V, et al. (1995) Indicators of life-threatening malaria in African children. N Engl J Med 332:1399–1404PubMedCrossRefGoogle Scholar
  51. Maitland K, Levin M, English M, Mithwani S, Peshu N, et al. (2003) Severe P. falciparum malaria in Kenyan children: Evidence for hypovolaemia. QJM 96:427–434PubMedCrossRefGoogle Scholar
  52. Martiney JA, Sherry B, Metz CN, Espinoza M, Ferrer AS, Calandra T, et al. (2000) Macrophage migration inhibitory factor release by macrophages after ingestion of Plasmodium chabaudi-infected erythrocytes: possible role in the pathogenesis of malarial anemia. Infect Immun 68:2259–2267PubMedCrossRefGoogle Scholar
  53. McGilvray ID, Serghides L, Kapus A, Rotstein OD, Kain KC (2000) Nonopsonic monocyte/ macrophage phagocytosis of Plasmodium falciparum-parasitized erythrocytes: a role for CD36 in malarial clearance. Blood 96:3231–3240PubMedGoogle Scholar
  54. Menendez C, Kahigwa E, Hirt R, Vounatsou P, Aponte JJ, Font F, et al. (1997) Randomised placebo-controlled trial of iron supplementation and malaria chemoprophylaxis for prevention of severe anaemia and malaria in Tanzanian infants. Lancet 350:844–850PubMedGoogle Scholar
  55. Minekura H, Kumagai T, Kawamoto Y, Nara F, Uchida K (2001) 4-Hydroxy-2-nonenal is a powerful endogenous inhibitor of endothelial response. Biochem Biophys Res Commun 282:557–561PubMedCrossRefGoogle Scholar
  56. Mohan K, Stevenson MM (1998) Dyserythropoiesis and severe anaemia associated with malaria correlate with deficient interleukin-12 production. Br J Haematol 103:942–949PubMedCrossRefGoogle Scholar
  57. Mohan K, Stevenson MM (1998) Interleukin-12 corrects severe anemia during blood-stage Plasmodium chabaudi AS in susceptible A/J mice. Exp Hematol 26:45–52PubMedGoogle Scholar
  58. Molyneux ME, Taylor TE, Wirima JJ, Borgstein A (1989) Clinical features and prognostic indicators in paediatric cerebral malaria: a study of 131 comatose Malawian children. QJM 71:441–459PubMedGoogle Scholar
  59. Newton CR, Krishna S (1998) Severe falciparum malaria in children: current understanding of pathophysiology and supportive treatment. Pharmacol Ther 79:1–53PubMedCrossRefGoogle Scholar
  60. Newton CR, Warn PA, Winstanley PA, Peshu N, Snow RW, Pasvol G, et al. (1997) Severe anaemia in children living in a malaria endemic area of Kenya. Trop Med Int Health 2:165–178PubMedCrossRefGoogle Scholar
  61. Njuguna P, Newton C (2004) Management of severe falciparum malaria. J Postgrad Med 50:45–50PubMedGoogle Scholar
  62. Nosten F, McGready R, Simpson JA, Thwai KL, Balkan S, Cho T, et al. (1999) Effects of Plasmodium vivax malaria in pregnancy. Lancet 354:546–549PubMedCrossRefGoogle Scholar
  63. Othoro C, Lal AA, Nahlen B, Koech D, Orago AS, Udhayakumar V (1999) A low interleukin-10 tumor necrosis factor-alpha ratio is associated with malaria anemia in children residing in a holoendemic malaria region in western Kenya. J Infect Dis 179:279–282PubMedCrossRefGoogle Scholar
  64. Pain A, Ferguson DJ, Kai O, Urban BC, Lowe B, Marsh K, et al. (2001) Platelet-mediated clumping of Plasmodium falciparum-infected erythrocytes is a common adhesive phenotype and is associated with severe malaria. Proc Natl Acad Sci USA 98:1805–1810PubMedCrossRefGoogle Scholar
  65. Paul REL, Brey PT, Robert V (2002) Plasmodium sex determination and transmission in mosquitos. Trends Parasitol 18:32–38PubMedGoogle Scholar
  66. Paul REL, Coulson TN, Raibaud A, Brey PT (2000) Sex determination in malaria parasites. Science 287:128–131PubMedCrossRefGoogle Scholar
  67. Perkins DJ, Weinberg JB, Kremsner PG (2000) Reduced interleukin-12 and transforming growth factor-beta1 in severe childhood malaria: relationship of cytokine balance with disease severity. J Infect Dis 182:988–992PubMedCrossRefGoogle Scholar
  68. Pichyangkul S, Saengkrai P, Webster HK (1994) Plasmodium falciparum pigment induces monocytes to release high levels of tumor necrosis factor-alpha and interleukin-1 beta. Am J Trop Med Hyg 51:430–435PubMedGoogle Scholar
  69. Planche T, Onanga M, Schwenk A, Dzeing A, Borrmann S, et al. (2004) Assessment of volume depletion in children with malaria. PLoS Med 1:e18PubMedCrossRefGoogle Scholar
  70. Price R, van Vugt M, Phaipun L, Luxemburger C, Simpson J, McGready R, et al. (1999) Adverse effects in patients with acute falciparum malaria treated with artemisinin derivatives. Am J Trop Med Hyg 60:547–555PubMedGoogle Scholar
  71. Riddle MS, Jackson JL, Sanders JW, Blazes DL (2002) Exchange transfusion as an adjunct therapy in severe Plasmodium falciparum malaria: a meta-analysis. Clin Infect Dis 34:1192–1198PubMedCrossRefGoogle Scholar
  72. Rowe JA, Moulds JM, Newbold CI, Miller LH (1997) P. falciparum rosetting mediated by a parasite-variant erythrocyte membrane protein and complement-receptor 1. Nature 388:292–295PubMedCrossRefGoogle Scholar
  73. Rowe JA, Scragg IG, Kwiatkowski D, Ferguson DJ, Carucci DJ, Newbold CI (1998) Implications of mycoplasma contamination in Plasmodium falciparum cultures and methods for its detection and eradication. Mol Biochem Parasitol 92:177–180PubMedCrossRefGoogle Scholar
  74. Schellenberg D, Menendez C, Kahigwa E, Aponte J, Vidal J, Tanner M, et al. (2001) Intermittent treatment for malaria and anaemia control at time of routine vaccinations in Tanzanian infants: a randomised, placebo-controlled trial. Lancet 357:1471–1477PubMedGoogle Scholar
  75. Scholander C, Carlson J, Kremsner PG, Wahlgren M (1998) Extensive immunoglobulin binding of Plasmodium falciparum-infected erythrocytes in a group of children with moderate anemia. Infect Immun 66:361–363PubMedGoogle Scholar
  76. Schwarzer E, Ludwig P, Valente E, Arese P (1999) 15(S)-hydroxyeicosatetraenoic acid (15-HETE), a product of arachidonic acid peroxidation, is an active component of hemozoin toxicity to monocytes. Parassitologia 41:199–202PubMedGoogle Scholar
  77. Schwarzer E, Muller O, Arese P, Siems WG, Grune T (1996) Increased levels of 4-hydroxynonenal in human monocytes fed with malarial pigment hemozoin. A possible clue for hemozoin toxicity. FEBS Lett 388:119–122PubMedCrossRefGoogle Scholar
  78. Schwarzer E, Turrini F, Giribaldi G, Cappadoro M, Arese P (1993) Phagocytosis of P. falciparum malarial pigment hemozoin by human monocytes inactivates monocyte protein kinase C. Biochim Biophys Acta 1181:51–54PubMedGoogle Scholar
  79. Schwarzer E, Turrini F, Ulliers D, Giribaldi G, Ginsburg H, Arese P (1992) Impairment of macrophage functions after ingestion of Plasmodium falciparum-infected erythrocytes or isolated malarial pigment. J Exp Med 176:1033–1041PubMedCrossRefGoogle Scholar
  80. Sexton AC, Good RT, Hansen DS, D’Ombrain MC, Buckingham L, Simpson K, et al. (2004) Transcriptional profiling reveals suppressed erythropoiesis, up-regulated glycolysis, and interferon-associated responses in murine malaria. J Infect Dis 189:1245–1256PubMedCrossRefGoogle Scholar
  81. Sherry BA, Alava G, Tracey KJ, Martiney J, Cerami A, Slater AF (1995) Malaria-specific metabolite hemozoin mediates the release of several potent endogenous pyrogens (TNF, MIP-1 alpha, and MIP-1 beta) in vitro, and altered thermoregulation in vivo. J Inflamm 45:85–96PubMedGoogle Scholar
  82. Silverman PH, Schooley JC, Mahlmann LJ (1987) Murine malaria decreases hemopoietic stem cells. Blood 69:408–413PubMedGoogle Scholar
  83. Snow RW, Omumbo JA, Lowe B, Molyneux CS, Obiero JO, Palmer A, et al. (1997) Relation between severe malaria morbidity in children and level of Plasmodium falciparum transmission in Africa. Lancet 349:1650–1654PubMedCrossRefGoogle Scholar
  84. Srichaikul T, Panikbutr N, Jeumtrakul P (1967) Bone-marrow changes in human malaria. Ann Trop Med Parasitol 61:40–51PubMedGoogle Scholar
  85. Stephens JWW (1937). Blackwater Fever. Liverpool, Univerisity of Liverpool PressGoogle Scholar
  86. Taverne J, Sheikh N, de Souza JB, Playfair JH, Probert L, Kollias G (1994) Anaemia and resistance to malaria in transgenic mice expressing human tumour necrosis factor. Immunology 82:397–403PubMedGoogle Scholar
  87. Tonelli M, Blake PG, Muirhead N (2001) Predictors of erythropoietin responsiveness in chronic hemodialysis patients. Asaio J 47:82–85PubMedGoogle Scholar
  88. Turrini FGG, Valente E, Arese P (1997) Mycoplasma contamination of Plasmodium cultures—A case of parasite parasitism. Parasitol Today 13:367–368PubMedCrossRefGoogle Scholar
  89. Vryonis G (1939) Observations on the parasitization of erythrocytes by Plasmodium vivax, with special reference to reticulocytes. Am J Hygiene 30:41Google Scholar
  90. Waitumbi JN, Opollo MO, Muga RO, Misore AO, Stoute JA (2000) Red cell surface changes and erythrophagocytosis in children with severe Plasmodium falciparum anemia. Blood 95:1481–1486PubMedGoogle Scholar
  91. Weatherall DJ, Ledingham (eds) The Oxford textbook of medicine. Oxford, Oxford University Press, 1987. Copyright DJ Weatherall, JGG Ledingham and DA WarrellGoogle Scholar
  92. Weiss L, Geduldig U, Weidanz W (1986) Mechanisms of splenic control of murine malaria: reticular cell activation and the development of a blood-spleen barrier. Am J Anat 176:251–285PubMedCrossRefGoogle Scholar
  93. Wickramasinghe SN, Looareesuwan S, Nagachinta B, White NJ (1989) Dyserythropoiesis and ineffective erythropoiesis in Plasmodium vivax malaria. Br J Haematol 72:91–99PubMedGoogle Scholar
  94. Wickramasinghe SN, Phillips RE, Looareesuwan S, Warrell DA, Hughes M (1987) The bone marrow in human cerebral malaria: parasite sequestration within sinusoids. Br J Haematol 66:295–306PubMedGoogle Scholar
  95. Winstanley P (2001) Modern chemotherapeutic options for malaria. Lancet Infect Dis 1:242–250PubMedGoogle Scholar
  96. Wongsrichanalai C, Pickard AL, Wernsdorfer WH, Meshnick SR (2002) Epidemiology of drug-resistant malaria. Lancet Infect Dis 2:209–218PubMedGoogle Scholar
  97. World Health Organization (1972) Nutritional Anaemia: World Health Organ Tech Rep Serv 503:1Google Scholar
  98. Wyler DJ (1983) The spleen in malaria. Ciba Found Symp 94:98–116PubMedGoogle Scholar
  99. Yeats J, Daley H, Hardie D (1999) Parvovirus B19 infection does not contribute significantly to severe anaemia in children with malaria in Malawi. Eur J Haematol 63:276–277PubMedGoogle Scholar
  100. Zamai L, Secchiero P, Pierpaoli S, Bassini A, Papa S, Alnemri ES, et al. (2000) TNF-related apoptosis-inducing ligand (TRAIL) as a negative regulator of normal human erythropoiesis. Blood 95:3716–3724PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2005

Authors and Affiliations

  • D. J. Roberts
    • 1
  • C. Casals-Pascual
    • 1
  • D. J. Weatherall
    • 1
  1. 1.Nuffield Department of Clinical Laboratory SciencesUniversity of Oxford and Blood Research Laboratory, John Radcliffe HospitalOxfordUK

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