Figure 1: Transfusion thresholds. As a general rule in critical care a restrictive approach would be to transfuse red cells when Hb < 7 g/dL, whereas in myelodysplasia and likely other bone marrow failure syndromes more practitioners would transfuse when Hb is <8-9 g/dL. Current trials in MDS, looking for a liberal transfusion threshold and improved QoL, may set this target up to 11 g/dL.