Refractory anemia with primitive cellularity is one of the five types of myelodysplastic syndromes. There are two typing criteria for myelodysplastic syndromes, FAB and WHO, and refractory anemia with primitive cellularity belongs to FAB. In the following, the diagnostic criteria, clinical manifestations and treatment are explained. 1. Under this typing standard, refractory anemia with primitive cellular proliferation refers to: the proportion of primitive cells in the peripheral blood is less than 5%, and the proportion of primitive cells in the bone marrow is 5%-20%. 2. This type of myelodysplastic syndrome is mainly characterized by a decrease in the total blood count, i.e., a decrease in the erythroid, granulocyte, and megakaryocyte lineages, and patients are prone to anemia, infections, and hemorrhages, and may be accompanied by an enlarged spleen and a rapid progression of the disease. There is also a higher chance that this type of disease will turn into leukemia. 3. Specific therapeutic drugs include cytarabine, zorubicin, decitabine, and so on. Therefore, when diagnosed with refractory anemia with primitive cellular proliferation, it is recommended to actively receive regular treatment under the guidance of a physician to avoid serious consequences.