At the bedside, recognition of pathognomonic macrocytic anaemia, cytoplasmic vacuoles and steroid-refractory inflammation has improved diagnostic speed, while retrospective cohorts have provided a first therapeutic hierarchy; glucocorticoids for initial control, JAK–STAT blockade and IL-6 inhibition for steroid-sparing, azacitidine when marrow dysplasia predominates, and allogeneic HSCT as the only proven curative option (52, 60, 65, 78). This evidence concerns the gene IL6 and macrocytic anemia.